Clinical question: Rule-out brain hemorrhage. Signs and symptoms: Fall and alteration of mental status. Nonenhanced head CT:No detectable acute intracranial hemorrhage, edema, mass effect, mass, midline shift or hydrocephalus.There is a focus of low-attenuation in the left posterior temporal subcortical and periventricular white matter with no involvement of overlapping cortex. This finding demonstrates no mass effect on the adjacent parenchyma or the ventricle. The finding likely represents a focus of encephalomalacia. Two entirely evaluate this finding recommend follow-up with an MRI exam. This finding could represent an area of chronic ischemic stroke however further evaluation is recommended.Calvarium is intact.Visualized paranasal sinuses, mastoid air cells and orbits are unremarkable.
1.No acute intracranial findings. CT is insensitive for early detection of acute ischemic strokes.2.Focus of low attenuation in the left posterior temporal subcortical/periventricular white matter could represent a focus of encephalomalacia however follow-up with an MRI is highly recommended to exclude other possibilities.