Clinical question: 73-year-old male with metastatic prostate cancer. Recent chemotherapy and thrombocytopenia with altered mental status. Signs and symptoms: Altered mental status. Non-enhanced head CT:Technique.Axial contiguous CT images of head were obtained. Sagittal and coronal 2-D reformatted images were also acquired.There is no any subacute intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus.The cortical sulci, ventricular system, CSF cisterns and gray -- white matter differentiation remains within normal.Calvarium is intact.Visualized paranasal sinuses, mastoid air cells and middle ear cavities are pneumatized and unremarkable.Images through the orbits demonstrate bilateral retro-orbital high density lesions that may represent very prominent bilateral superior ophthalmic veins or bilateral retro-orbital masses (hemangiomas). Correlate with patient's history and physical exam. This finding can be further evaluated with a dedicated MRI examination of orbits.
1.Unremarkable CT examination of brain.2.There prominent bilateral superior ophthalmic veins and or retro-orbital hemangiomas. Please correlate with history and direct physical exam and if clinically warranted recommend further follow-up with dedicated MRI examination of orbits.