20 year-old female with pain status post fall and trauma to head and positive loss of consciousness. There is no evidence of intracranial hemorrhage, mass or edema. A nonspecific focus of low attenuation is present within the white matter just adjacent to the right frontal horn which appears to represent encephalomalacia. This is nonspecific and of unknown etiology. Correlation with clinical history and possibly further evaluation with MRI as clinically indicated to further determine etiology.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.CERVICAL SPINE: There is minimal straightening of the visualized cervical spine secondary to positioning for the examination. Cervical spine alignment is within normal limits without evidence of spondylolysis or spondylolisthesis. Vertebral body heights and intervertebral disk spaces are within normal limits. The pre-and paravertebral soft tissues are within normal limits. The airway is patent.Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. If there is clinical concern for spinal cord or ligamentous injury, an MRI may be considered.
1. No evidence of fracture or intracranial hemorrhage.2. Normal cervical spine without evidence of fracture or malalignment.3. Focus of low attenuation adjacent to right frontal horn appears to represent encephalomalacia. This is nonspecific and of unknown etiology. Correlation with clinical history and possibly further evaluation with MRI as clinically indicated to further determine etiology.