Clinical question: Evaluate intracranial hemorrhage, cerebral edema. Signs and symptoms: Worsening hepatic encephalopathy. Unenhanced CT of brain:Patchy areas of periventricular and subcortical low attenuation although nonspecific could represent small vessel disease of indeterminate age. Considering provided clinical data all hepatic encephalopathy these findings may represent edematous changes from hepatic encephalopathy. There is no evidence of any associated mass-effect with his findings. Prior examination from 6 -- 2 -- 2010 was performed with a helical CT and imaging quality was not as good as the current exam and precise comparison is difficult.There is no evidence of hemorrhage, mass-effect, midline shift or hydrocephalus. Follow up would and MRI can significantly improved the assessment.
Diffuse patchy areas of subcortical and periventricular low attenuation with no associated hemorrhage, mass-effect or midline shift as detailed. Please see above comments.