69 year-old female with altered mental status, dysarthria, pronator drift. Evaluate for acute stroke. There is no CT evidence of acute territorial ischemia. There are patchy areas of hypodensity within the subcortical, deep, and periventricular white matter that are nonspecific, however most commonly small vessel ischemic disease of indeterminate age. If there is a high index of suspicion for acute infarct, MRI would be more sensitive.The ventricles and sulci are mildly prominent, likely due to age-related volume loss. There is no acute intracranial hemorrhage or extraaxial collection. There is no midline shift or basal cistern effacement.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are clear.There is moderate atherosclerotic calcification of the intracranial vessels.
1.No CT evidence of acute territorial ischemia. MRI would be more sensitive for acute infarction if there is strong clinical suspicion for acute infarct. 2.Moderate chronic small vessel ischemic disease.