What Does this MRI Scan Result Mean?

MRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collectionMRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This MRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collectionMRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collectionMRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collectionMRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collection MRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collection MRI Brain & Stem WO Cont Patient: JASE TALLEY DOB: Oct 21, 2016 READ CLINICAL INFORMATION: 3-month-old male found unresponsive. EXAMINATION: MRI BRAIN & STEM WO CONT, 2/13/2017 3:47 PM, MR0000 COMPARISON: CT brain study 02/12/2017. TECHNIQUE: Sagittal BRAVO imaging, axial diffusion tensor imaging, axial T1, T2-weighted, FLAIR, SWAN, coronal diffusion-weighted imaging with ADC mapping, coronal FLAIR and STIR imaging of the brain was performed without intravenous contrast. FINDINGS: There is restricted diffusion involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres. This corresponds to the area of decreased attenuation seen on the prior CT brain study dated 2/12/2017. There is corresponding cortical T2 prolongation with associated cortical fullness consistent with edema, most pronounced in the parietal and occipital lobes (seen for instance on series 5 image 21). On diffusion-weighted imaging, there is relative sparing of the deep craniocaudal (series 402 image 25). There is approximately 5 mm thick extra-axial fluid collection overlying the left frontal lobe, as measured perpendicular to the calvarium on series 9 image 27. This collectiondemonstrates T1 and T2 prolongation, incomplete suppression on FLAIR imaging, and there are areas of susceptibility hypointensity along the superior margin of the collection (series 6 image 81). There is no significant mass effect upon the subjacent brain parenchyma. The size is approximately unchanged since the comparison CT, given differences in technique. There is no evidence of mass effect, or midline shift. There is preservation of CSF within sulci overlying both cerebral hemispheres, and the perimesencephalic cisterns remain patent. The ventricular system is normal in size and configuration. There are bilateral mastoid effusions. The orbits are unremarkable. There are no focal suspicious marrow lesions. There are findings suggestive of splaying of the calvarial sutures. IMPRESSION: 1. There is diffuse diffusion restriction involving nearly the entirety of both cerebral hemispheres, as well as portions of both cerebellar hemispheres, consistent with sequelae of global hypoxic ischemic injury. 2. There are no intracranial signs of impending herniation, however there is likely some degree of splaying of the calvarial sutures. 3. There is a subdural collection with signs suggestive of internal blood products overlying the left frontal lobe, similar in size to the comparison CT. There is no significant mass effect upon the subjacent brain parenchyma. The findings were reviewed in person by the pediatric radiology fellow Dr. Majmudar with Dr Dai Kimura of the intensive care unit at 20:20 on 02/13/2017. COMMENTS: I have reviewed the images and discussed the findings with the resident, Anand Majmudar M.D. I have reviewed and agree with the final report above. This report was dictated at Workstation ID: PLA5138