53-year-old male with history of CVA presents with dizziness, upward deviation of the left eye and dizziness. Please evaluate for intracranial hemorrhage, CVA. There is no evidence of intracranial hemorrhage, mass or edema. Loculated lacunar infarct within the left basal ganglia and head of the caudate with adjacent ex vacuo dilatation of the frontal horn. Multiple scattered low densities noted with the bilateral cerebellar hemispheres. There is a small focus of encephalomalacia within the posterior aspect of the right occipital lobe which is too small to determine age. If there is clinical concern for acute ischemia, an MRI may be considered.Multiple is areas of intracranial vascular calcifications. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Multiple hypodensities in the distribution of the bilateral superior cerebellar arteries are suspicious for small strokes which are too small to determine age. MRI is recommended for further evaluation, if clinically warranted.