65 year old with loss of consciousness rule out bleed The examination is somewhat compromised by patient motion. In several areas there is poor differentiation of gray white junction with the suggestion of subcortical hypodensity. In addition the sulci and basilar cisterns are small and I cannot rule a possibly of some increased intracranial pressure.I recommend obtaining an MRI with diffusion weighted imaging to evaluate.There is no evidence of intracranial hemorrhage as clinically questioned.Bone windows reveal no osseous abnormality.
Somewhat compromised examination by patient motion does demonstrate poor definition of the gray white junction as well as suggestion of subcortical hypodensities. Cerebral sulci and basilar cisterns are somewhat small for the patient's stated age and the possibility of diffuse edema cannot be excluded. MRI of the brain is recommended to fully evaluate.