Acute mental status changes. Nonverbal. Question bleed. There is no evidence of intracranial hemorrhage, mass or or midline shift. Extensive areas of subcortical and periventricular white matter hypodensity likely represent small vessel ischemic disease, age indeterminate by CT. If there is concern for an acute stroke, an MRI may be considered for further evaluation. A lacunar infarct is noted in the left basal ganglia. Prominence of the sulci and ventricles is consistent with corticomedullary volume loss.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Small vessel ischemic disease, age indeterminate. No evidence of acute infarction by CT. However, an MRI may be considered if there is concern for acute stroke.