CT HEAD WITHOUT CONTRAST:
CLINICAL HISTORY: 30-year-old female with history of rheumatic fever as a child, status post mechanical valve replacement, complicated by intraoperative pulmonary artery rupture and cardiac arrest. CT head obtained for fixed and dilated pupils.
FINDINGS:
Parenchyma, ventricles, and extra-axial spaces: There is diffuse cerebral edema with poor grey-white differentiation throughout the brain. There is upward transtentorial and
cerebellar tonsillar herniation.
Visualized paranasal sinuses: Partial opacification of the bilateral sphenoid sinuses. Frothy material is seen within the right sphenoid sinus as well as bilateral maxillary sinuses.
Mastoid air cells: Bilateral mastoid effusions. Fluid is also seen in the bilateral middle ear cavities.
Bones: No focal abnormality.
Additional comment: None.
IMPRESSION:
1. Severe, diffuse cerebral edema with upward transtentorial and tonsillar cerebellar herniation, and effacement of basal cisterns.