91-year-old female status post fall without loss of consciousness. Evaluate for bleed or fracture. There is no evidence of intracranial hemorrhage, mass or edema. Multiple diffuse hyperdensities in a periventricular distribution consistent with advanced small vessel disease, age indeterminate. There is a focus of hyperdensity within the right frontal horn which may represent calcification but we cannot rule out the remote possibility of hemorrhage. If further evaluation is clinically warranted MRI may be considered. Small lacunes are noted within the bilateral basal ganglia consistent with chronic ischemic changes.Prominent sulci in proportion to ventricles are within normal limits for age. The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Advanced small vessel disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.2. A small focus of hyperdensity within the right frontal horn is likely due to calcification but a focus of hemorrhage cannot be ruled out.