Clinical question: No acute intracranial abnormality. Bleed, metastases. Signs and symptoms: history of metastatic prostate cancer. New onset of headaches for one week associated with eye pain and balance problems Nonenhanced head CT:There is no evidence of intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus. A very subtle area of low-attenuation with apparent involvement of cortex and subcortical white matter of left frontal lobe is present. The exact etiology of this finding is not clear however the finding could represent small ischemic stroke. The age of this is stroke cannot be determined due to small size. On this non-infused exam there is no evidence of metastatic disease. Recommend an MRI for further evaluation. Calvarium is intact. Mastoid air cells and paranasal sinuses are unremarkable.
1.Small focus of low-attenuation in the left frontal lobe likely result of ischemic stroke. Recommend further follow-up with MRI since the small size of this lesion makes precise determination of its age difficult.2.No evidence of metastatic disease on this non-infused study.3.Calvarium is intact.