Findings: MRI of brain with T1 weighted echo train spin echo, T2 weighted
echo train spin echo, T2 weighted fluid-attenuated inversion
recovery echo train spin echo, MR diffusion imaging, chemical shift
MR imaging with metabolite map, and with intravenous gadolinium-
enhancement:
1. Small amount long T1 and T2 crescent fluid accumulation in left
frontoparietal subdural space without restricted water
diffusibility (figure 1 and red arrow in figure 2), but with
small short T1 and T2 structures content (yellow arrows in
figure 3-5), in favor of subdural effusion with some blood clots of
extracellular methemoglobin, nature to be determined.
2. Presence of patchy thickening of left pachymeninges with
some contrast enhancement (green arrows in figure 3-5, more
obvious on post-Gd T2WI FLAIR images than post-Gd T1WI images),
and gadolinium diffusion/leakage into left subdural space (blue
arrows in figure 3-5), possibly associated with increased membrane
permeability of meninges.
3. Small right subdural effusion (white arrow in figure 2) with mild
patchy thickening of right pachymeninges with some contrast
enhancement.
4. No evidence of leptomeningeal enhancement.
5. Relative thinning of corpus callosum (figure 6), predominant over
body and splenium, callosal hypogenesis can not be excluded.
6. Enlarged subarachnoid spaces without ventricular enlargement,
suggesting external hydrocephalus (benign enlargement of the
subarachnoid space).
7. No abnormal finding in remaining brain.
No detectable abnormal metabolism.
Impression:
1. Bilateral subdural effusion with increased permeability of left
meninges and some blood clots within left subdural effusion.
2. Corpus callosum hypogenesis.