59-year-old female presents with altered mental status an lethargy. There is no evidence of acute intracranial hemorrhage or midline shift. There is redemonstration of areas of encephalomalacia involving the right insular cortex, right temporal and right frontal lobes in the distribution of the right middle cerebral artery. There is also encephalomalacia in the left posterior cerebral artery involving the left occipital lobe.The ventricles and basal cisterns are unchanged in appearance compared to prior exam, including small right frontal horn.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1.No acute intracranial hemorrhage or midline shift.2.Stable multiple areas of encephalomalacia.3.CT is insensitive for the early detection of non-hemorrhagic CVA. MRI should be considered if clinical suspicion for CVA persists. 