79-year-old female with hypertension now with progressive lower extremity weakness x 1 day. Generalized weakness x 2 weeks. No objective neuro findings on exam. Question acute ischemia. Question subdural hematoma. Patient has very poor gait. Patchy areas of deep subcortical and periventricular white matter hypodensity likely represent moderate small vessel ischemic disease, age indeterminate by CT. However, if there is concern for an acute stroke, an MRI is recommended for further evaluation. There is no evidence of intracranial hemorrhage, mass or midline shift. Prominence of the sulci and ventricles indicates mild to moderate corticomedullary volume loss.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Small vessel ischemic disease, age indeterminate. If there is concern for an acute stroke, an MRI is recommended for further evaluation.