If a person has had a left frontotemporal craniotomy several years ago and seems to be functioning fine until being injured in an automobile accident, is it possible that they could have suffered a trauma to the brain without it showing up on the Head CT scan that was performed in the ER?  Her head hit the windshield.  The CT shows status post left frontotemporal craniotomy, with associated encephalomalacia.    This encephalomalacia causes ex vacuo dilatation of the left lateral ventricle, and some subtle right-to-left midline shift.  No acute abnormality seen.  This individual had an aneurysm about 20 years ago.
Hi, Thank you for posting your query. In most cases of severe head injury, CT scan of brain would show abnormalities. So, if the CT does not show any acute abnormalities, then, it is unlikely she has suffered any serious internal brain injury. The findings reported in the current CT represents the old changes. Please get back if you require any additional information. Best wishes, Chat Doctor. Ly/