87 Year-Old With Delirium After A Recent Fall

This is unpublished
CT noncontrast.
CT noncontrast
CT noncontrast.
CT noncontrast
Axial FLAIR.
Axial FLAIR
Gradient Echo.
Gradient Echo
T1 Axial.
T1 Axial
T1 sagittal.
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