43-year-old man with hypertension, altered mental status in the setting of ESRD. There is no evidence of intracranial hemorrhage or mass. Subtle low attenuation is present in the subcortical white matter. This is nonspecific and most likely signifies age-indeterminate small vessel ischemia. In the proper clinical setting, this finding could also represent sequela of PRES.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are diffusely sclerotic, possibly indicating renal osteodystrophy. There is groundglass opacification and sclerotic bone formation around the left chamber of the frontal sinus. This is most suggestive of fibrous dysplasia but could be better evaluated with MRI.
1. Widespread subcortical white matter hypoattenuation -- this finding is nonspecific and most likely represents age-indeterminate small vessel ischemic disease. This could also represent sequela of PRES. If clinically indicated, MRI could provide further evaluation.2. Groundglass opacification and bony remodeling involving the left chamber frontal sinus -- possibly representing fibrous dysplasia. This finding could also be better evaluated with MRI.