74-year-old with a history of TIA, peripheral vascular disease, diabetes, status post carotid endarterectomy, brought to the ER after physical therapy with suspected facial droop and slurred speech. Now at baseline per daughter. Rule out acute ischemic or hemorrhagic event. There is no evidence of intracranial hemorrhage, mass, edema or midline shift. Patchy areas of subcortical and periventricular white matter hypodensity likely represent small vessel ischemic disease of indeterminate age. However, if there is concern for an acute stroke, an MRI is recommended for further evaluation.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Small vessel ischemic disease of indeterminant age. No definite acute findings, however if there is concern for an acute stroke an MRI is recommended for further evaluation.