Medical question: Rule out intracranial hemorrhage. Signs and symptoms: Altered mental status, respiratory failure, anemia. Nonenhanced CT of brain:A there is revisualization of bilateral symmetrical ventriculomegaly of lateral ventricles as well as the third ventricle. This remains identical to prior examination from 6 -- 7 -- 2010.Very minimal periventricular low-attenuation is again identified. These may represent minimal small vessel disease of indeterminate age. The cortical sulci remain within normal size and disproportionately smaller than the ventricular system. All of the findings remain stable since prior exam. Prominence of ventricular system may be at the upper limits of normal for patient's stated stated age of 78. Possibility of hydrocephalus however cannot be entirely excluded. There are no additional older studies for comparison.Also stable since prior exam is expansion of the left cavernous sinus in size possible minimal associated bony remodeling this finding is best the patient or axial images 7 and 8. There is no evidence of calcification within the cavernous sinus to suggest this finding is secondary to atherosclerotic tortuosity and ectasia of the internal carotid. I recommend follow-up with an MRI to exclude possibility of a mass in this location and in particular a meningioma.
1.No evidence of any new acute finding since prior exam.2.Stable uniform bilateral enlargement of lateral ventricles and minimally of the third ventricle. Finding may represent central atrophy or hydrocephalus. Follow-up with an MRI is recommended.3.Prominent soft tissue density of left cavernous sinus with expansion remains stable since prior study. Recommend follow-up with an infused MRI for assessment of tumor.