55 year-old female with fall, head trauma and possible seizure. BRAIN: There is no evidence of intracranial hemorrhage, mass or edema. Multifocal regions of patchy hypoattenuation are present in a subcortical and periventricular deep white matter distribution, nonspecific; however, most likely represent small vessel ischemic disease, age indeterminate. No acute cortical infarction. If there is clinical concern for acute ischemia, MRI may be considered.Area of hypoattenuation located in the left frontal region, most likely encephalomalacia secondary to prior infarction.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized except for a small retention cyst in the left frontal sinus.CERVICAL SPINE:The cervical spine alignment is anatomic. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. The pre-vertebral and paraspinal soft tissues are within normal limits. Limited view of the lung apices demonstrate bullous change and emphysema.Multilevel degenerative disk changes are noted as follows:C2-3: Disk osteophyte complex with central protrusion without central or neuroforaminal narrowing.C3-4: Disk osteophyte complex with diffuse disk bulge without central or neuroforaminal narrowing.C4-5: Disk osteophyte complex with right neuroforaminal narrowing. No central canal narrowing.C5-6: Disk osteophyte complex with severe right greater than left mild neuroforaminal narrowing. No central canal narrowing.C6-7: Uncovertebral joint hypertrophy, osteophyte spurring. No central or neuroforaminal narrowing.Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of significant spinal canal stenosis.
1. Diffuse intracranial parenchymal volume loss without acute abnormalities such as hemorrhage or acute cortical stroke.2. White matter disease as described above, nonspecific however most likely represent small vessel ischemic disease.3. Multilevel degenerative disease of the cervical and visualized upper thoracic spine, not significantly changed compared to the previous examination.4. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.