Syncope.IMAGE ACQUISITIONS: 5-mm contiguous axial CT sections of the brain without contrast infusion. No acute intracranial hemorrhage, mass effect or shift of midline structures.There are multiple patchy areas of low attenuation in cerebral white matter both in deep white matter and in juxtacortical white matter, a nonspecific finding but atypical for age, either representing chronic ischemic/degenerative change or possibly demyelination. Consider follow-up MRI of the brain for further evaluation, as indicated clinically.There is no depressed calvarial fracture. Craniofacial structures are unremarkable.
Extent of patchy white matter low attenuation is greater than expected for patient's age. If there is underlying risk for accelerated atherosclerosis such as diabetes or hypercholesterolemia, or if the patient has hypertension, the finding could be explained by this. Demyelination is not excluded. Follow-up as indicated clinically.