Clinical question: Memory loss. Evaluate for chronic vascular changes. Non-infused head CT:Images through posterior fossa again identify a right-sided cerebellopontine angle extra axial primarily fatty density mass measuring 14.7 x 11.6-mm in size. There is no appreciable interval change in the size or morphology of this lesion. Finding likely present a lipoma however an MRI examination is recommended for more precise evaluation. Images through posterior fossa are otherwise unremarkable.Anatomical variation of partially empty sella is also again identified with no change.Images supratentorial space demonstrate diffuse patchy areas of low attenuation in the subcortical and periventricular white matter of bilateral cerebral hemispheres. Although nonspecific these findings however are often result of small vessel ischemic strokes. These findings were present on prior exam and precise comparison is not possible.There is no evidence of intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. Calvarium is intact. Visualized orbits, mastoid air cells and middle ear cavities are unremarkable.Limited images of the paranasal sinuses again demonstrate complete opacification of right chamber of the sphenoid sinus with no change since prior examination from 2008.
1.Small vessel disease of indeterminate age.2.Revisualization of complete opacification of right chamber of sphenoid sinus.