Clinical question: Assess for intracranial hemorrhage. Signs and symptoms: Found down. Nonenhanced head CT:There is no detectable acute intracranial process.CT is insensitive for early detection of acute ischemic strokes.Excessive premature a subcortical low attenuation white matter is nonspecific caliber considering patients age likely representing small vessel ischemic strokes of indeterminate age.Mild expansion of right temporal horn secondary to minimal right anterior temporal tip encephalomalacia.Calvarium and soft tissues of the scalp are unremarkable.Limited images through the paranasal sinuses are unremarkable.Limited images through the orbits are unremarkable.There is evidence of a C1 fracture involving both the anterior and posterior arch on the right. There is mild compromise of the spinal canal at this level. This finding is not associated with any associated surrounding soft tissue abnormality and likely to present a chronic fracture. Recommend dedicated CT of cervical spine and/or MRI for further assessment.Findings on this exam were discussed on the phone with Dr. Juan Rojas # 3577at the time of review of the study.
1.Small muscle ischemic stroke of indeterminate age. CT is insensitive for the detection of nonhemorrhagic acute strokes.2.No acute intracranial process.3.Right anterior temporal tip encephalomalacia and resultant ex vacuo dilatation of right temporal horn.4.Fracture of C1 anterior and posterior arch without any associated surrounding soft tissue abnormality. The finding is highly suspect a chronic fracture. Recommend follow-up with dedicated CT and or MRI for better assessment.