71-year-old male with acute altered mental status. Evaluate for intracranial hemorrhage. There is no evidence of intracranial hemorrhage, mass or edema. No evidence of acute cortical ischemia. Multifocal regions of patchy low attenuation throughout the periventricular and subcortical deep white matter, nonspecific, however most likely secondary to small vessel ischemic disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.Focal region of encephalomalacia along the left temporoparietal region, not grossly changed compared with the previous examination of 4/23/2005.The ventricles and basal cisterns are mildly enlarged secondary to volume loss.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. No evidence of acute cortical infarction. Left temporoparietal encephalomalacia secondary to previous infarction. Diffuse white matter change most likely secondary to small vessel ischemic disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.3. No evidence of intracranial hemorrhage.