84-year-old female with altered mental status x 1 week and visual hallucinations. Chronic headache. Question of ischemic stroke. There is no evidence of intracranial hemorrhage, mass or edema. Multiple areas of periventricular and subcortical white matter hypodensity consistent with small vessel ischemic disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered. Well-defined focal hypodensity adjacent to the left basal ganglia consistent with old hemorrhagic stroke. No acute cortical stroke.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.
Prior strokes and small vessel ischemic disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.