Clinical question to be answered: Rule out bleed or hematoma. Signs and symptoms: Mental status change. Examination demonstrates a gyriform area of increased density in the high convex to the left parietal cortex (axial image 20). This finding is associated with an adjacent area of encephalomalacia . The finding is believed to represent calcific changes of an area of old stroke which was noted on prior MRI exam. Less likely possibility of a new small hemorrhagic cortical stroke cannot be entirely ruled out. Prominence of cortical sulci and folia of the cerebellum as well as prominence of the ventricular system is concerning for underlying parenchymal volume loss.
See above comments.