54-year-old male with a history of right-sided weakness. Evaluate for acute stroke. There is no evidence of intracranial hemorrhage, extra-axial fluid collection, mass or edema. There is no mass effect or midline shift. There is preservation of the gray-white matter interface. There is no evidence of acute territorial ischemia. Periventricular hypoattenuation is nonspecific, but most consistent with small vessel ischemic disease of indeterminate age, appearing similar to the prior study. Additionally, note is made of punctate foci of hypoattenuation in the left internal capsule, and right thalamus, likely representing age indeterminate lacunar infarcts. The focus of hypoattenuation in the left internal capsule appears more prominent when compared to the prior study. While this may be related to technique, if strong clinical concern for acute ischemia, further evaluation with MRI could be considered.The ventricles and basal cisterns are normal in size and configuration. There is no effacement of the basal cisterns. The calvaria and skull base are radiographically normal. The visualized mastoid air cells and paranasal sinuses are within normal limits.
1. No evidence of acute territorial ischemia or intracranial hemorrhage. It should be noted that CT is insensitive in detecting acute, nonhemorrhagic stroke. 2. Hypoattenuation in the left internal capsule, and right thalamus are nonspecific, but most consistent with age indeterminate lacunar infarcts. The focus of hypoattenuation in the left internal capsule appears more prominent when compared to the prior study. While this may be related to technique, if strong clinical concern for acute ischemia, further evaluation with MRI could be considered.3. Hypoattenuation in the periventricular and subcortical white matter, are nonspecific but most consistent with small vessel ischemic disease of indeterminate age, appearing similar to the prior study.