Clinical question: Rule out stroke. Signs and symptoms: Focal weakness, altered mental status. Nonenhanced head CT:Examination demonstrate mild-to-moderate degree of small vessel ischemic disease of indeterminate age. There is a left frontal periventricular white matter foci of low-attenuation which is believed to represent a lacunar infarct. Prominence size of this lesion (8 times 14-mm) may suggest acute state of this lesion. Please correlate with clinical exam and follow-up with an MRI if clinically is warranted.The cortical sulci, ventricular system and CSF cisterns remain within normal limits.There is no evidence of hemorrhage, mass-effect, midline shift or hydrocephalus.
1.Small vessel ischemic disease of indeterminate age.2.A lacunar infarct in the left frontal periventricular white matter appears prominent in size and measuring 8 times 14-mm. This finding could represent an acute lacunar infarct due to its large size. Please correlate with history and physical exam and if clinically warranted follow-up with an MRI.