Rule out CVA. Patient with two days of left-sided weakness. Several areas of encephalomalacia, the largest in the right occipital lobe that likely represent areas of prior infarct. Multiple areas of subcortical and periventricular white matter hypodensity indicate small vessel ischemic disease of indeterminate age. An MRI is recommended if there is clinical concern for acute stroke.There is no evidence of intracranial hemorrhage, mass or midline shift. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Areas of encephalomalacia and evidence of small vessel ischemic disease of indeterminate age. An MRI is recommended for further evaluation if there is concern for an acute stroke.