Clinical question: Please evaluate for. Signs and symptoms: Headaches, lethargy and on anticoagulant Nonenhanced CT of brain: Examination demonstrates a large area of low-attenuation primarily in the subcortical white matter of right posterior frontal -- parietal with atrophic changes of overlapping cortex. This finding could represent an ischemic stroke however the appearance may also be secondary to edema from malignancy. There is no definitive mass effect with the above finding and to exclude other possibilities an MRI examination is recommended. There is no evidence of hemorrhage, mass effect, midline shift or hydrocephalus.
1.Area of low-attenuation in the subcortical white matter of right posterior frontal could represent an old stroke however to exclude possibility of an underlying malignancy MRI examination is recommended.2.There is no evidence of intracranial hemorrhage midline shift or hydrocephalus.