50 year-old female with difficulty talking and mouth pain. History of previous acute coronary syndrome. There is no evidence of intracranial hemorrhage, mass or edema. Bifrontal low attenuation is present most likely secondary to encephalomalacia from previous ischemic event. However, the right frontal region demonstrates vague hypoattenuation extension to the cortex may be artifactual but acute ischemic change is not completely excluded. Low-attenuation region in the right cerebellar hemisphere may represent an area of ischemic change, also age indeterminate.Increased density material is present within the anterior falcine region/left frontal hemisphere consistent with surgical clip metallic artifact from prior intervention. Please correlate with prior surgical history. Superior to this metallic artifact is an ovoid high-density structure measuring 5 x 10 mm, (series 3, image 20) which may represent a meningioma however could also potentially represent an aneurysm. Further examination with MRA/MRI with contrast is recommended for further evaluation.The ventricles and basal cisterns are normal in size and configuration.Postsurgical changes of a left frontal craniectomy are noted. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. No definite acute intracranial abnormality.2. Bifrontal low attenuation with questionable image artifacts versus ischemic change of indeterminate age of the right frontal hemisphere.3. Ovoid subcentimeter high-density structure adjacent to the anterior falx which may represent a meningioma however could potentially represent an aneurysm. Further evaluation with MRA/MRI with contrast is recommended for further evaluation.