Neuro_CT_Head: 87 M, report of "mass" at OSH.

CT HEAD WITHOUT CONTRAST:

CLINICAL HISTORY: 87 years of age, Male, one month of worsening headache, dizziness, constitutional symptoms, had CT in Mexico this past month and was reportedly told he had a tumor.

FINDINGS: 

Parenchyma: There is an irregular hypodense region in the right parietal lobe measuring approximately 3.2 x 2.9 x 5.1 cm (TR x AP x CC) with questionable foci of intrinsic hyperdensity concerning for blood products or possibly septations. Notably, there is no significant local or regional mass effect in this region. No ex vacuo dilatation of the adjacent right occipital horn is seen to suggest encephalomalacia. The overlying calvarium is intact without erosion or scalloping.  Subarachnoid blood products are also noted over the left posterior parietal lobe. 

Ventricles and extra-axial spaces: Appropriate for age. 

Visualized paranasal sinuses: Mild mucosal thickening of the left posterior ethmoid air cells. 

Mastoid air cells: Clear. 

Bones: No acute osseous abnormality. No soft tissue findings are demonstrated to suggest recent trauma. 

Additional comment: Bilateral lens replacements. 

IMPRESSION: 

1.  Irregular hypodense region in the right parietal lobe with suspected associated blood products is nonspecific and indeterminate. This may represent ischemic, inflammatory, posttraumatic (although no corroborative findings of soft tissue or calvarial trauma are identified, there is evidence of sulcal subarachnoid hemorrhage as described below) or neoplastic (although less likely given lack of mass effect) etiologies.  Recommend further characterization with contrast-enhanced MRI brain and comparison with prior studies if available. 

2.  Subarachnoid hemorrhage over the left posterior parietal lobe.