 There is extensive encephalomalacia within the bilateral anterior frontal lobes and to a lesser degree the bilateral anterior temporal lobes. There is a background of scattered patchy high T2 signal within the subcortical and periventricular white matter. There are scattered areas of susceptibility effect scattered along the bilateral cerebral convexities and a punctate focus of susceptibility effect in the left occipital horn of the left lateral ventricle. There is ex vacuo dilatation of the left greater than right frontal horns of the lateral ventricles as well as prominence of the cortical sulci and prominence of the ventricles compatible with moderate diffuse cerebral volume loss. There is no evidence of mass effect or midline shift. There are no areas of abnormal intracranial enhancement. There is trace mucosal thickening within the paranasal sinuses. There are bilateral lens implants. The skull and scalp soft tissues are unremarkable.
1.Bilateral anterior frontal and temporal lobe encephalomalacia is compatible with remote traumatic brain injury.2.Scattered areas of hemosiderosis and a punctate focus of susceptibility effect in the left occipital horn of the left lateral ventricle indicate chronic hemorrhage.3.Scattered cerebral white matter T2 hyperintensity is nonspecific, but may represent chronic small vessel ischemic disease, but no evidence of acute infarction.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.