Presentation
Ventilated after head injury, does not regain consciousness.
Patient Data
Small hemorrhagic focus in right thalamus. Several SWI-hypointense foci spread scattered in the cerebral white matter, mostly right frontal and temporal and to a lesser extent, left frontal. The largest foci are right thalamic and right temporal, both FLAIR-hyperintense. Additional tiny hemorrhagic foci in the trigones of the lateral ventricles.
No evidence of involvement of the corpus callosum or the brainstem.
No evidence of infarction or mass lesion.
Normal appearance of ventricles, cisterns and sulci.
Non-specific T2/FLAIR hyperintensities in the periventricular and subcortical white matter and in the white matter of the right cerebellar hemisphere.
Normal structure of the posterior fossa.
No pathological post-contrast enhancement.
Normal appearance of the circle of Willis and its branches on TOF MRA.
Normal signal return from the venous sinuses.
Free craniocervical junction.
Thickened mucosa in right maxillary sinus.
Case Discussion
Hemorrhagic foci in the bifrontal subcortical and right temporal periventricular white matter, the right thalamus, and in the lateral ventricles. Given the immediate history of trauma, consistent with stage 1 diffuse axonal injury (DAI).
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