Clinical question: Fracture? Signs and symptoms: Altered mental status, fall. Nonenhanced head CT:No detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp the findings.Very extensive periventricular and subcortical low attenuation white matter of bilateral cerebral hemispheres is consistent with advanced small vessel ischemic strokes of indeterminate age. A small left high convexity posterior frontal chronic cortical stroke is also present.Extensive cavernous carotid vascular calcification and bilateral intracranial vertebral calcifications are noted. Limited images through the orbits are unremarkable. Paranasal sinuses and mastoid air cells are well pneumatized.CT of the cervical spine:No evidence of fracture or malalignment.Moderate to advanced degenerative disk disease, multi-level with significant bulging disks and ventral disk -- osteophyte complex formation is noted.Multi-level neural foraminal compromise secondary to degenerative changes is present. Multi-level mild central spinal stenosis is suspected.This findings can be more accurately evaluated with a dedicated MRI examination of cervical spine.Unremarkable perispinal soft tissues.
1.Nonenhanced head CT demonstrates no acute posttraumatic findings. Extensive small vessel ischemic strokes of indeterminate age.2.Nonenhanced cervical CT demonstrates no acute fracture or malalignment. Moderate to advanced degenerative changes of cervical spine with resultant multi-level neural foraminal compromise and suspected central spinal stenosis.