74 year-old man with history of CVA two years ago with right-sided weakness. Now alert and oriented x 0 with increased right-sided weakness. There are multiple areas of periventricular, subcortical, and cortical hypodensity. The most prominent is a region of cortical hypodensity with encephalomalacia in the left occipital lobe. This was present on the prior study dated 5/8/2006. There is a smaller left parietal hypodensity which was also present on the prior study. The subcortical hypodensities in the left parietal region appear more pronounced on the current study. MRI could better determine whether or not this represents an acute event. There are no CT findings 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.
1. Increased prominence of left parietal subcortical hypodensities. MRI is recommended to evaluate for acute stroke.2. Stable findings of periventricular, subcortical, and cortical hypodensities consistent with prior stroke and small vessel ischemic disease.2. No CT evidence of intracranial hemorrhage.