Demographics:
65 years old, Male
Indication:
Stroke follow-up
Findings
- Heterogeneous hypoattenuation and loss of gray-white differentiation in the posterior left frontal lobe and left insula with cortical-based curvilinear hyperattenuation along the superior aspect
- Partial effacement of multiple left cerebral convexity sulci without midline shift, hydrocephalus, or evidence of herniation
- Sequela of chronic small vessel disease with global cerebral volume loss and ex vacuo dilation of the ventricular system
- Calcified intracranial atherosclerosis
- Mild mucosal thickening of the paranasal sinuses
Diagnosis
Petechial hemorrhage vs cortical laminar necrosis
Sample Report
Likely subacute left MCA territory infarct with cortical-based curvilinear hyperattenuation along the superior aspect consistent with cortical laminar necrosis and/or areas of petechial hemorrhage. No organized parenchymal hematoma.
Associated edema results in partial effacement of multiple left cerebral convexity sulci without midline shift, hydrocephalus, or evidence of herniation.
Sequelae of chronic small vessel disease with global cerebral volume loss and ex vacuo dilation of the ventricular system. Calcified intracranial atherosclerosis.
Discussion