Neuro_CT_Head: 33 F, intraoperative cardiac arrest.

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. 

 

Ventricles and extra-axial spaces: Effacement of the basilar cisterns. Relatively hyperdense appearance of the tentorium and subarachnoid spaces likely represent pseudo-subarachnoid and pseudo-subdural hemorrhages.

 

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.