Acute onset weakness left-sided and slurred speech. Extensive areas of hypoattenuation are seen in the periventricular and subcortical white matter consistent with small vessel ischemic disease, age indeterminant. No definite acute cortical stroke is present. However, further evaluation with MRI is recommended if clinical concern acute ischemia is present. Circumscribed low density lesions are seen in the bilateral basal ganglia and right peri-atrial white matter consistent with lacunar infarcts. No intracranial hemorrhage is seen. Subarachnoid space is prominent suggestive of parenchymal volume loss. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Extensive small vessel ischemic disease, age indeterminant. 2. No evidence of acute cortical stroke. MRI is more sensitive for detection of acute ischemia.