Neutropenic fever. History of leukemia.IMAGE ACQUISITIONS: 1.5-mm contiguous axial images of the brain without contrast infusion.2.Thin section axial and reformatted coronal images of paranasal sinuses without contrast infusion. Low-attenuation in involving right internal capsule and periatrial white matter and small portion of right medial temporal lobe is consistent with infarct, likely in the right anterior choroidal artery territory, as previously described on MRI. There is no acute intracranial hemorrhage, mass effect or shift of midline structures. Small white matter infarcts over the cerebral convexities that were present on the previous MRI are not as well demonstrated on CT due to decreased sensitivity CT compared MRI.On previous CT of sinuses the March 11, 2009, there was mild mucosal thickening in the right side of the sphenoid sinus. On the current scan, there is some frothy or bubbly secretion in the right side of the sphenoid sinus, which is new compared with the previous scan. Minimal mucosal thickening is again noted in the right maxillary antrum. There are no other areas of mucosal thickening. There are no fluid levels. There is no bone obstruction or sinus expansion.. Ostiomeatal complexes are structurally normal. Mastoids are mostly included in the field of view and are well aerated.Bilateral proptosis is again noted.
1.Chronic right anterior choroidal artery infarct is again noted. CT of the brain is otherwise negative.2.There is some frothy secretion in the sphenoid sinus on the right. This has developed since the previous scan and could indicate early acute inflammation.