Clinical question: rule-out acute bleed or mass. Signs and symptoms : history of metastatic cancer.? Microhemorrhage on previous MRI. Now with headaches. Nonenhanced head CT:A punctate focus of high density in the left cerebellum measuring 2.5-mm is noted on axial image 10. This finding was not detected on prior head CT from 3 -- 31 -- 11 and could represent minimal hemorrhage.A single focus of subcortical low attenuation measuring approximately 5 mm in transaxial dimension in the subcortical white matter of right frontal lobe is similar to prior exam and is a nonspecific finding. Possibility of an old small vessel stroke should be considered. This finding was present on prior MRI examination from 6 -- 5 -- 11 as well.There is no evidence of any additional foci of abnormality. The cortical sulci, ventricular system and all CSF cisterns remain within normal.
1.Small punctate focus of high density in the left cerebellum may represent minimal bleed.2.Possible minimal small vessel disease.