75-year-old female with history of multiple CVAs now presents with increased altered mental status and muscle twitches. Please evaluate for new bleed, mass effect or shift. Compared to previous to evaluate progression of CVA. There is no evidence of intracranial hemorrhage, mass or edema. The previously described there is low attenuation throughout the MCA vascular territory the left consistent with a subacute infarct but remains overall unchanged from the previous examination. Multiple other areas of hypodensity in the periventricular and subcortical white matter distribution is consistent with small vessel disease, age indeterminant. Multiple lacunar infarcts redemonstrated within the bilateral basal ganglia and cerebellum. If there is clinical concern for acute ischemia, an MRI may be considered.The ventricles and basal cisterns are stable in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Stable right frontoparietal subacute infarct. 2. Small vessel disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.