90 year-old female with acute mental status changes. Diffuse periventricular and subcortical white matter hypodensity indicates diffuse small vessel ischemic disease. Prominence of the sulci and ex vacuo dilatation of the ventricles indicates moderate to severe corticomedullary volume loss.Hypodense focus in the left cerebellar hemisphere with an adjacent area of increased attenuation is nonspecific but could represent infarction, tumor, or even blood. A contrast-enhanced CT or preferably an MRI is indicated for further evaluation of this area.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Hypodense left cerebellar focus with adjacent area of increased attenuation is nonspecific. A contrast enhanced CT or preferably an MRI is indicated for further evaluation of this lesion.2. Diffuse small vessel ischemic disease and volume loss.