Mental status changes, homicidal thoughts. Off Zoloft. Patchy areas of subcortical and periventricular white matter hypodensity likely represent small vessel ischemic disease, age indeterminate by CT. There is no evidence of intracranial hemorrhage, mass, midline shift or extra axial fluid collection. The ventricles and basal cisterns appear symmetric.A fixation plate in the left periorbital region is noted which would not preclude the patient from getting an MRI. An old buckle fracture of the right zygomatic arch is again noted. There is partial opacification of the left maxillary sinus. The remaining visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Stable examination without acute intracranial abnormality. Small vessel ischemic disease, age indeterminate.