Sickle cell disease. Right arm numbness/weakness today that is resolving. Evaluate for CVA. Multiple subcortical and periventricular white matter hypodensities in the bilateral frontal and parietal lobes are compatible with small vessel ischemic disease. Most of these areas were present on the prior examination. However, an MRI would be helpful in evaluating for an acute infarct. There is no evidence of intracranial hemorrhage, mass or edema. Prominence of the sulci and ventricles consistent with corticomedullary volume loss. No midline shift.The calvarium is thickened, likely reflecting extramedullary hematopoiesis in a patient with sickle cell disease. This appears similar to the prior examination. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Moderate small vessel ischemic disease, similar in appearance to the prior examination. However, an MRI would be helpful in evaluating for an acute infarct as clinically indicated.