Presentation
Left sided diminution of vision, past history of trauma.
Patient Data
Patient has a history of head injury; status post left frontoparietal craniotomy. The study reveals multiple gliotic areas with foci of old hemorrhage in left temporal and bilateral basifrontal lobes causing ex-vacuo dilatation of temporal horn of left lateral ventricle. Multiple tiny foci of old hemorrhage seen at grey-white matter junction in bilateral frontal lobes. Foci of old extra-axial hemorrhage seen along left frontoparietal convexity.
Atrophy and hyperintensity of intraorbital, intracanalicular and intracranial segments of the left optic nerve is seen. Right optic nerve appears normal.
Partially empty sella is seen with pituitary gland mildly flattened against sellar floor.
Cerebellum and brain stem are unremarkable. Major signal void areas of brain are normal. No obvious mass lesion seen in orbits / cavernous sinuses. No sella / suprasellar mass seen. Bilateral extraocular muscles are normal.
Case Discussion
Atrophy and hyperintensity of intraorbital, intracanalicular and intracranial segments of left optic nerve consistent with optic atrophy. This is likely related to past trauma.
Multiple gliotic areas with foci of old hemorrhage in left temporal and bilateral basifrontal lobes causing ex-vacuo dilatation of temporal horn of left lateral ventricle, likely sequelae of hemorrhagic contusions.
Multiple tiny foci of old hemorrhage seen at grey-white matter junction in bilateral frontal lobes, likely sequelae of diffuse axonal injury.
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