Clinical question: Rule-out acute intracranial bleed. Signs and symptoms: Acute altered mental status. CT of brain without infusion:Large vessel intracranial vascular calcification of carotids and vertebral arteries are again identified. Very minimal scattered patchy areas of low-attenuation in the periventricular and subcortical white matter of bilateral cerebral hemispheres are concerning for minimal small vessel disease. Age of these is strokes cannot be determined on CT. Precise comparison with the prior examination for detection of new or small vessel stroke is not possible. Small vessel disease was noted on prior CT and MRI exam.No evidence of hemorrhage, edema, mass effect, midline shift or hydrocephalus is detected. Calvarium, paranasal sinuses and mastoid air cells are unremarkable.
Findings consistent with small vessel disease of indeterminate age.