63-year-old male with generalized weakness, questionable aspiration pneumonia, and partial left facial droop. Evaluate for left-sided stroke. Questionable loss of gray-white differentiation in the right frontal region raises the possibility of acute stroke, though this may be further characterized by MRI. Encephalomalacia in the left MCA territories compatible with prior stroke. There is no intracranial hemorrhage or abnormal extra-axial fluid collections. The ventricles are midline, with normal volume and morphology.The calvaria and other osseous structures are intact. Visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Loss of gray-white differentiation in the right frontal lobe may represent acute stroke, with no evidence of acute intracranial hemorrhage. Further evaluation by MRI is recommended.2. Evidence of old stroke in the left MCA territory.