Case Notes
History
38 yo male w/ Hx hypertension, diffuse rash, chrohn's dz, seizures, brain cysts (biopsied benign), who now presents with stairing spells and acute fatique. Years earlier the patient had surgical drainage of a parenchymal hemorrhage in the left frontal vertex area.Exam
CTA of the head
Prior Study
Noncontrast CT headThere are brain changes of chronic nature, which are likely the sequelae of a neonatal TORCH encephalopathy. No apparent hyperacute abnormality is evident
CT Perfusion
Possible focal left cortical stroke in the distal left lateral frontal artery territory but whether it is acute ischemia or reduced perfusion on a chronic basis is indeterminate.
CT perfusion changes, likely chronic, within both cerebral hemisphere matching the areas of chronic leukomalacia consistent with the sequelae of a perinatal TORCH infection.