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Case #9

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Demographics: 80 years old, Female
Indication: Posttraumatic headache

Findings

  • High attenuation material layering in the left occipital horn and in the right cerebellopontine angle cistern, concerning for acute hemorrhage
  • Left parieto-occipital scalp hematoma without subjacent calvarial fracture
  • Partial opacification of the left mastoid air cells and middle ear
  • Right frontal approach ventriculostomy catheter terminates in the right frontal horn with hypoattenuation along the catheter track
  • Diffuse cerebral volume loss with scattered areas of subcortical and periventricular white matter hypoattenuation
  • Subtotal opacification of the left sphenoid sinus with intermixed high attenuation material

Diagnosis

Intraventricular hemorrhage

Sample Report

High attenuation material layering in the left occipital horn and in the right cerebellopontine angle cistern, concerning for acute hemorrhage. No mass effect or hydrocephalus.

Left parieto-occipital scalp hematoma without subjacent calvarial fracture. Partial opacification of the left mastoid air cells and middle ear without definite temporal bone fracture. This finding could alternatively relate to inflammatory or infectious otomastoiditis.

Right frontal approach ventriculostomy catheter terminates in the right frontal horn with hypoattenuation along the catheter track likely representing gliosis.

Diffuse cerebral volume loss with scattered areas of subcortical and periventricular white matter hypoattenuation which though nonspecific likely represents sequela of chronic microvascular ischemia in this age group.

Subtotal opacification of the left sphenoid sinus with intermixed high attenuation material which may represent inspissated secretions or chronic fungal colonization.

Discussion

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