75 years Male (DOB:7/25/1941)Reason: right mediofrontal scalp wound with exposed cranium, eval for osteomyelitis History: scalp woundPROVIDER/ATTENDING NAME: KEVIN C. CONCORDIA DAVID G. BEISER The calvarial marrow signal appears to be appropriate bilaterally there is not appear to be in the marrow replacement.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells demonstrate partial opacification of the mastoid air cells on the right side than the left and opacification of the right middle ear. The visualized portions of the orbits are intact.
1.The patient's right frontal scalp tissues are not associated with marrow replacement. This suggests that underlying osteomyelitis is less likely.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Opacification of mastoid air cells (right side more than left) and right middle ear is nonspecific and could be simply related to retained secretions. This was also present on the prior CT exam. Early mastoiditis may have a similar appearance however. Please correlate with clinical symptoms