Clinical question: Rule out intracranial bleed. Signs and symptoms: Stroke. CT of brain without infusion:Crowding of the cerebellar tonsils at the level from the magnum is again identified. Images through posterior fossa demonstrates minimal encephalomalacia along the medial aspect of right cerebellum. This area demonstrated acute stroke on prior MRI examination off January 29 of 2010. There is no evidence of any hemorrhage within the posterior fossa. Fourth ventricle remains normal and in midline. Images through the supratentorial space are essentially unremarkable and no evidence of hemorrhage, edema, mass-effect, midline shift or hydrocephalus.Paranasal sinuses, mastoid air cells, middle ear cavities and calvarium are unremarkable.
1.Small area of low attenuation likely encephalomalacia or edema in the distribution of the right pica is consistent with patient's known prior right pica stroke.2.No evidence of any new area of stroke or hemorrhage is detected.