Presentation
Episode of slurred speech.
Patient Data
No acute intracranial hemorrhage identified. Small left pontine hypodensity. Periventricular and deep white matter hypoattenuation, most in keeping with chronic small vessel ischemia. Grey-white differentiation is preserved. Ventricular size, sulcal pattern and basal cisterns are normal for age. No bony abnormality identified.
Conclusion: New left pontine hypodensity is suspicious for ischemic stroke. As the posterior fossa is often affected by artifact correlation with follow-up imaging would be worthwhile.
The previously demonstrated area of hypoattenuation involving the pons on the left has become better delineated, consistent with an evolving infarct
Case Discussion
Posterior fossa strokes can be difficult to detect or be certain of as there is often a substantial amount of artifact. This case demonstrates CT follow-up has confirmed the suspected pontine stroke with increasing size and conspicuity of the left pontine hypodensity.