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Cytotoxic oedema of the right insular cortex and right inferior frontal gyrus, most in keeping with acute right MCA territory infarct, particularly with right anterior middle frontal gyrus encephalomalacia consistent with an old MCA infarct. Diffuse deep white matter chronic small vessel ischaemic changes. No intracranial haemorrhage. Ventricles and sulci are prominent, in keeping with age related volume loss.
Left frontotemporal scalp superficial swelling. No calvarial or base of skull fracture. Osteopenia. Minor mucoperiosteal thickening in the left maxillary sinus.