Clinical question: Possible. Signs and symptoms: Fall Nonenhanced CT of brain:There is no evidence of acute post traumatic intracranial findings.Findings consistent with minimal small vessel disease of indeterminate age is noted.Cortical sulci, ventricular system and CSF cisterns remain within normal for patient of stated age of 87. Large vessel intracranial calcification of carotid and vertebral arteries are noted.Limited view of paranasal sinuses and mastoid air cells are unremarkable.Gadolinium demonstrate a large area of low attenuation within the marrow space in the right frontal lobe with suspected area also thinning of the inner cortex of right frontal bone. There is no associated epidural component with this finding. Findings could represent fibrous dysplasia however less likely possibility of a metastatic lesion cannot be entirely ruled out. There are no additional foci of abnormality of calvarium. This finding can be further evaluated either by a nuclear medicine study or a dedicated MRI of brain with enhancement.
1. No evidence of post traumatic findings of intracranial space or the calvarium.2.Findings consistent with minimal small vessel disease of indeterminate age.3.Large area of lytic change involving the right frontal bone which may represent fibrous dysplasia and less likely possibility of a metastatic lesion cannot be entirely ruled out. Follow up with neck medicine bone scan or an MRI of brain with enhancement is recommended.