87 year-old with delirium after a recent fall
CT noncontrast
CT Noncontrast
Axial FLAIR
Gradient Echo
T1 Axial
T1 sagittal
Findings:
Multiple foci of acute hemorrhage some within bifrontal foci of cystic encephalomalacia.
DDX:
For the chronic bifronal lesions: trauma, infarct, surgical
Diagnosis:
Frontal lobotomy in this patient with long history of psychiatric disease.
Discussion:
Approximately
40,000 frontal lobotomies were performed in the USA between 1940 and
1970. There are characteristic symmetric and coronally oriented
clefts created in the frontal lobes.
Submitted by Dean Shibata, MD, UW Neuroradiology
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