85 year-old female with facial asymmetry and left hand weakness. There is redemonstration of a left temporal craniotomy with underlying extensive encephalomalacia in the left frontotemporal and ex vacuo dilatation of the left lateral ventricle, unchanged when compared to the previous study. There is no new parenchymal lesion or CT evidence of acute territorial ischemia. MRI would be more sensitive for small or acute infarctions.There is no acute intracranial hemorrhage or extraaxial collection. The ventricles and sulci are stable with ex vacuo dilation of the left lateral ventricle as noted earlier. No midline shift or basal cistern effacement.The visualized mastoid air cells and paranasal sinuses are within normal limits. Orbits unremarkable. Redemonstration of debris within the extra auditory canals bilaterally.
1. No evidence of acute intracranial hemorrhage or CT evidence of acute territorial ischemia. MRI is offered as a more sensitive test should there be a high degree of suspicion for acute infarction.2. Stable left temporal lobe encephalomalacia underlying prior craniotomy site consistent with prior left MCA infarct.