Clinical question: Status post stroke, rule out hemorrhagic transformation. Signs and symptoms: Aphagia. Nonenhanced CT of brain:A subacute nonhemorrhagic right frontal lobe cortical stroke with subtle associated mass effect on the adjacent cortical sulci is identified. This finding was poorly visible on prior CT study, however it was well identified on prior MRI.Subacute left posterior temporal -- occipital nonhemorrhagic cortical stroke is again identified and with no appreciable change. Extensive findings of small vessel disease. No evidence of any new foci of cortical stroke, hemorrhage, mass-effect is identified. Prominence of cortical sulci and ventricular system as well as in the folia of the cerebellum and vermis are again identified and with no change. Old lacunar infarct of pons is again identified.
1.Redemonstration of right frontal and left posterior temporal -- occipital nonhemorrhagic subacute cortical stroke.2.Advanced small vessel disease of indeterminate age.3.No evidence of acute new findings and in particular no evidence of breakthrough hemorrhage of above described subacute cortical strokes.