Clinical question: Rule out bleed. Signs and symptoms: Confusion, altered mental status. No evidence of hemorrhage, edema, mass effect, midline shift or hydrocephalus. Cortical sulci, ventricular system and all CSF cisterns remain within normal. A very small subtle foci of subcortical -- periventricular low attenuation in the left frontal lobe is noted. There is no associated mass effect or parenchymal volume loss. The finding may represent minimal small vessel disease. Please correlate with history and follow up grade a post infusion CT exam or an MRI is recommended. There are no old studies for comparison.
Small nonspecific foci of left frontal subcortical low attenuation as described. The finding may represent minimal small vessel disease of indeterminate age. Follow-up with an MRI is recommended.