Clinical question of CVA. Signs and symptoms: Left-sided facial numbness. Nonenhanced head CT:No detectable acute intracranial process.CT is insensitive for early detection of acute ischemic strokes.Examination demonstrates small focus of low attenuation in the left paramedian pons which is not a specific however it could represent an age indeterminate lacunar infarct. Consider MRI if concern for a stroke remains high.Unremarkable cortical sulci, ventricular system, CSF cisterns and gray -- white matter differentiation.Paranasal sinuses are unremarkable.There is evidence of an old blowout fracture of left floor of the orbit as well as lamina papyracea.
1.Minimal small vessel ischemic strokes of indeterminate age.2.No acute intracranial hemorrhage, mass effect or hydrocephalus.