Right-sided weakness. History of CVA. Evaluate for ICH. There is a 4.1 x 3.4 cm subtle focal area of abnormal attenuation in the left vertex (image 21/30 on series 4) with a suggestion of surrounding vasogenic edema which may represent a mass which has increased in size when compared to the prior exam from 2006. Further evaluation of this lesion is recommended with a contrast-enhanced CT or MRI. Low attenuation in the periventricular and subcortical white matter is likely due to prior small vessel ischemia. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Possible mass in the left vertex as described above. Further evaluation with a contrast-enhanced CT or MRI is recommended. The ER was notified of these findings at 9:30 a.m. on 9/18/09.