Clinical question: 67 year old male with RA, COPD and hypertension. Admitted with cavitary pulmonary lesion with confusion. Signs and symptoms: Confusion. Non-enhanced CT of brain:Examination demonstrates no evidence of hemorrhage, edema, mass effect, midline shift or hydrocephalus. Cortical sulci, ventricular system and all CSF cisterns remain within normal. There is only a suspect a single focus of low-attenuation in the subcortical white matter of the right frontal lobe (image 21 of 32). Considering clinical history of hypertension this may represent a small subcortical stroke of indeterminate age. Follow-up with an MRI is recommended.Calvarium is intact. Mastoid air cells are well pneumatized. Extensive sinus disease of visualized paranasal sinuses
1.With the exception of a very small foci of low-attenuation in subcortical white matter of right frontal lobe this is study is within normal limits. This finding may represent small vessels stroke of indeterminate age.2.Extensive sinusitis all visualized paranasal sinuses.