An extensive left-sided cranial decompression has been performed. The left cerebral hemisphere has herniated beyond the margins of the craniectomy site and there is mild (~6mm at level of 3rd ventricle) midline shift to the right, consistent with successful decompression. Diffuse FLAIR signal hyperintensity involves almost the entire left cerebral hemisphere, correlating with extensive ICA territory regional diffusion restriction.
A large amount of blood product within, particularly involving the left parietal lobe and left basal ganglia. Small volume intraventricular blood.
Flattening left lateral ventricle and mild prominence of the right,
Flow is now visible in the left intracranial ICA and the left M1/M2 divisions of the middle cerebral artery.
The remainder of the circle of Willis vessels are unremarkable.