Clinical question: Rule out CVA. Signs and symptoms: Right upper and lower extremity weakness. Nonenhanced head CT:Large vessel intracranial calcification of bilateral vertebral and cavernous carotids are noted. Images through posterior fossa are unremarkable.On axial images 11 and 12 there is a focus of low attenuation in the pons on the left extending across the midline. This is believed to represent artifact. Please correlate with neurological examination findings and if concern persists recommend and MRI.Images through the supratentorial space demonstrate no detectable hemorrhage, edema, mass effect, midline shift or hydrocephalus. There is a slight prominence of cortical sulci and ventricular system which may represent mild underlying parenchymal volume loss.
1.No definitive acute intracranial findings.2.Foci of low-attenuation in the pons on the left which also extend across the midline to the right and is believed to represent an artifact. Please correlate with neurological findings and if there is concern for stroke in this region recommend follow-up with CT or an MRI.