Neuro_CTA_Head: 30 M, AMS and fever, hemorrhage.

CT HEAD WITHOUT CONTRAST:

 

CLINICAL HISTORY: 30 years of age, Male, progressive altered mental status and headache.

 

FINDINGS:

 

Parenchyma, ventricles, and extra-axial spaces: Rounded hyperdensity representing hemorrhage in the right suprasellar cistern/uncus is new, as is linear hemorrhage along the right mesial temporal lobe more posteriorly with surrounding edema. There is also edema in the anteroinferior right temporal lobe. Mass effect with mild leftward midline shift. No definite abnormality in the left temporal lobe.

 

Visualized paranasal sinuses: Mild opacification of the left posterior ethmoid air cells.

 

Mastoid air cells: Clear.

 

Bones: No focal abnormality.

 

Additional comment: None.

  

IMPRESSION:

 

1.  Edema with mass effect in the anterior right temporal lobe and right mesial temporal lobe, with focal hemorrhages in the right 

mesial temporal lobe and overlying the right uncus. No definite vascular abnormality seen to account for hemorrhage. Given rapid 

development of edema in the temporal lobe and associated hemorrhage, encephalitis, specifically HSV encephalitis, is primary 

consideration. Venous thrombosis could also have this appearance however no thrombosed vein is identified. Further evaluation with MRI to better characterize parenchymal findings and look for possible 

contralateral involvement is recommended.