4 weeks post infarct
Left craniectomy again demonstrated. Extensive hypodensity involving the entire left MCA territory is again noted in keeping with infarction. Haemorrhage in the left frontal lobe adjacent the anterior horn of the lateral ventricle is denser and more extensive compared to previous in keeping with intercurrent haemorrhage. There are also traces of hyperdense subarachnoid blood in the left hemisphere. The previously seen posterior frontal, periventricular and temporal haematomas are less conspicuous.
The ventricle have increased in size. As a reference, the 3rd ventricle now measures 12 mm in diameter and there is dilatation of both lateral ventricles, including the temporal horns in keeping with increasing hydrocephalus. A trace of blood persists in the occipital horn of the right lateral ventricle.
CONCLUSION: Increasing hydrocephalus.
Extensive left MCA territory infarct with evidence of interim left frontal haemorrhage since the previous studies.