 There are no areas of restricted diffusion to suggest acute ischemic infarction. There are several foci of abnormal signal compatible with subacute hemorrhage within the supratentorial brain parenchyma involving the left frontal, right parietal, bilateral temporal, and left occipital lobes appearing grossly similar to the recent CT. The largest focus of hemorrhage is in the left posterior temporal lobe and measures approximately 9 x 14 mm. These areas of hemorrhage are surrounded by varying amounts of increased T2/FLAIR signal compatible with vasogenic edema. Additional punctate foci of decreased signal on susceptibility-weighted images within the bilateral cerebral hemispheres is nonspecific but may reflect additional foci of chronic microhemorrhage. Increased FLAIR signal is present within the cortical sulci most prominent in the bilateral frontal and occipital lobes compatible with subarachnoid hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The midline structures and craniocervical junction are within normal limits. Partial opacification of the paranasal sinuses and mastoid air cells is likely related to endotracheal intubation.There is no abnormal intracranial enhancement.
1.Multiple foci of subacute intraparenchymal hemorrhage within the bilateral cerebral hemispheres without associated significant mass effect. Additional punctate foci of susceptibility artifact in the bilateral cerebral hemispheres may reflect chronic microhemorrhages. Areas of hemorrhage may be related to bleeding diathesis and recent cardiac arrest. Given distribution, amyloid angiopathy is an additional differential consideration.2.Subarachnoid hemorrhage within the cortical sulci; continued follow-up is recommended as clinically warranted.3.No evidence of acute ischemic infarction.4.No abnormal enhancing lesions are detected.Findings discussed with Dr. PATEL, PARITA at 11:15 a.m. on 8/24/2015. 