Neuro_CT_Head: 68 F, with steno-occlusive disease, infarct and hemorrhage after EC-IC bypass.

CT HEAD WITHOUT CONTRAST:

 

CLINICAL HISTORY: 66-year-old with postoperative extra-axial collection, nonreactive pupil.

 

FINDINGS:

 

Parenchyma and extra-axial spaces: Cortical and subcortical edema involving the majority of the anterior right frontal lobe, patchy areas of the posterior right frontal lobe, and right parietal lobe, compatible with infarct, with significant mass effect with with leftward midline shift up to 16 mm, subfalcine and uncal herniation with obliteration of the basal cisterns. There is entrapment of the left lateral ventricle. Extra-axial hemorrhage including subdural and subarachnoid component is without significant change, with further resorption of postoperative air.

 

Visualized paranasal sinuses: Clear.

 

Mastoid air cells: Clear.

 

Bones: Stable post craniotomy changes.

 

Additional comment: None.

 

IMPRESSION:

 

1. Significant interval increase in right frontal and parietal infarct with associated edema resulting in significant midline shift to 16 mm, subfalcine and uncal herniation, and entrapment of the left lateral ventricle. Degree of extra-axial hemorrhage is without significant change in size from prior exam, change in mass effect is primarily due to parenchymal swelling.