Clinical question: Evaluate for prior strokes. Signs and symptoms: Dementia. Non-enhanced head CT:There is no detectable hemorrhage, edema, mass-effect, midline shift or hydrocephalus. The cortical sulci, ventricular system and CSF cisterns remain all within normal patient stated age of 86. Very minute amount of periventricular low attenuation could represent minimal small vessel disease of indeterminate age. Entirely exclude a small vessel ischemic stroke as the cause for dementia recommend an MRI examination.Calvarium is intact. Visualized paranasal sinuses and mastoid air cells are unremarkable.
Very minimal small vessel ischemic disease of indeterminate age is suspected. Examination is otherwise unremarkable for patient stated age of 86. MRI examination would significantly better assess the extent of small vessel disease.