75-year-old male with right arm weakness and slurred speech. Evaluate for acute stroke. Reidentified is a focal area of hypoattenuation involving the left temporoparietal region compatible with encephalomalacia secondary to prior infarct. No new hemorrhage identified. There is mild ex vacuo dilation of the left occipital horn secondary to adjacent volume loss. No evidence of hydrocephalus.No evidence of acute ischemia, however, CT is insensitive for the evaluation of early ischemic change; if there is clinical concern for acute ischemia, an MRI may be considered.There is no evidence of intracranial hemorrhage, mass or edema. The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. No acute intracranial abnormalities are present including hemorrhage, mass-effect, or edema.2. No evidence of acute ischemia, however, CT is insensitive for the evaluation of early ischemic change; if there is clinical concern for acute ischemia, an MRI may be considered.