76-year-old woman with INR greater than 15.2 who presents status post fall. There is no evidence of intracranial hemorrhage or mass. Old left occipital and left cerebellar strokes with relative sparing of the medial temporal lobe. Ex vacuo dilatation of the ventricles consistent with ischemic volume loss. No cortical stroke. Extensive small vessel disease anteriorly, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered. The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Chronic ischemic changes as described above. If there is clinical concern for acute ischemia, an MRI may be considered.