54 year old female with hypertension, headaches, altered mental status. Please evaluate for evidence of acute bleed. There is a subcortical hypodense region in the right frontal lobe which likely represent ischemic changes of indeterminate age. MRI is recommended for further evaluation.Diffuse subcortical white matter hypodensities likely represent small vessel skin disease of indeterminate age.The ventricles and basal cisterns are normal in size and configuration.An old left zygomatic arch buckle fracture is noted. An old right zygomatic arch nonhealed fracture is noted. Additional fracture in the lateral wall of the orbits and bilateral surgical wires in the zygomatic arches are noted. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Right frontal lobe hypodensity may represent ischemic changes of indeterminate age with additional diffuse white matter hypodensities that may represent small vessel skin disease. MRI is recommended for further evaluation. No evidence of intracranial hemorrhage.