Clinical question: Rule out new CVA. Signs and symptoms: Left upper extremity pain Nonenhanced head CT:There is no evidence of intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. Small focal low attenuation in the subcortical and periventricular white matter of right frontal lobe is again identified however it appears larger than prior to study. Possibility of a new overlapping stroke cannot be ruled out and follow-up with an MRI is recommended. The density of area of low attenuation however is suggestive of an old chronic stroke.
Focal area of low-attenuation in the subcortical white matter of right frontal lobe consistent with an old stroke as described above.