Demographics:
83 years old, Male
Indication:
Frequent falls
Findings
- Global ventriculomegaly and cerebral volume loss with a borderline acute callosal angle (~90 degrees, normal = 100-120 degrees) and confluent periventricular hypoattenuation
- Calcified intracranial atherosclerosis
- Inflammatory mucosal thickening of the paranasal sinuses
Diagnosis
Ex vacuo ventriculomegaly vs normal pressure hydrocephalus
Sample Report
Global ventriculomegaly which may represent ex vacuo dilation in the setting of diffuse cerebral volume loss. However, given confluent periventricular white matter hypoattenuation, a borderline acute callosal angle (~90 degrees, normal = 100-120 degrees), and the reported clinical history of frequent falls, normal pressure hydrocephalus should be considered.
No evidence of acute large vascular territory infarct, mass effect, or hemorrhage. However, CT is relatively insensitive for the detection of acute infarct in the first 24-48 hours and MRI should be considered if there is ongoing clinical concern.
Discussion