Somnolence [R40.0], Reason for Study: ^Reason: 57M with h/o laryngeal SCC, DVT/PE, recent GI bleed with persistent AMS, eval for anatomic causes History: AMS No evidence of acute ischemic or hemorrhagic lesion on the scan.No evidence of abnormal enhancement.FLAIR high signal intensities on periventricular white matter and brainstem area are nonspecific which may indicate small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Retention cyst in the left maxillary sinus.
1.No evidence of acute ischemic or hemorrhagic lesion. 2. No evidence of abnormal enhancement.3. Nonspecific FLAIR high signal intensities, possible small vessel ischemic disease.