Assess for cause for increased confusion in patient with dementia and left retro-bulbar mass. There is no evidence of intracranial hemorrhage or midline shift. Patchy areas of subcortical and periventricular white matter hypodensity likely represent small vessel ischemic disease of indeterminant age. Prominence of the ventricles and sulci indicate corticomedullary volume loss. No specific findings to indicate acute ischemia. However if there is concern for an acute stroke, an MRI may be helpful for further evaluation.Limited views of the orbit shows an ill-defined soft tissue within the left orbit posterior to the globe with proptosis and deformation of the left globe is again noted. When accounting for differences in technique the size of this mass and enhancement appears decreased when compared to the prior MRI exam.The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Small vessel ischemic disease of indeterminate age. No findings to indicate acute ischemia. However, if there is concern for an acute stroke an MRI is recommended for further evaluation.2. Ill-defined left orbital soft tissue mass with proptosis and deformation of the left globe. Suggestion of interval decrease in size when compared to the prior MRI exam performed 3/12/08.