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87 year-old with delirium after a recent fall

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