Patient is post operative case of head injury with craniotomy changes on right side.
Gliotic areas with chronic hemorrhage are seen in right temporal and occipital lobes, causing exvacuo dilatation of temporal, occipital horns of right lateral ventricle.
Gliotic areas with hemorrhage also seen in bilateral frontal lobes, right cerebellar hemisphere, left temporal lobe, mid brain and pons.
Punctate foci of hemorrhage are seen along gray white matter interface of bilateral cerebral hemisphere, along septum pellucidum, body of left lateral ventricle, corpus callosum, mid brain, pons, left superior cerebellar peduncle and right cerebellar hemisphere.
Subarachnoid hemorrhage is seen with serpiginous areas of hemorrhage along convexity sulci of right frontal lobe.
Enlargement with hyperintensity is seen involving bilateral inferior olivary nuclei.
Lacunar infarcts and areas of ischemic demyelination are seen in pons, bilateral middle cerebellar peduncle, periventricular deep and subcortical white matter.
Case Discussion
Enlargement with hyperintensity is seen involving bilateral inferior olivary nuclei consistent with hypertrophic olivary degeneration.
Sequelae of prior trauma viz. hemorrhagic contusions, diffuse axonal injury and subarachnoid hemorrhage as described.
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