52-year-old female with severe hyponatremia (sodium 122) and altered mental status. Non-contrast head CT to evaluate for intracranial process.

None available.

Axial non-contrast CT images of the head were acquired with reconstructed images in standard brain and bone windows.

No acute intracranial hemorrhage. No mass effect. Sulci and ventricles are appropriate for stated age. Scattered subcortical and periventricular white matter hypodensities in the frontoparietal regions, consistent with mild chronic microangiopathic small vessel disease (Fazekas grade 1). No territorial infarct or other acute parenchymal abnormality.

Normal in size and configuration. No midline shift.

EXTRA-AXIAL SPACES: No subdural or epidural collection. No effacement of the basal cisterns.

Mild generalized cerebral volume loss, mildly advanced for stated age but without focal asymmetry.

Cerebellum and brainstem unremarkable. Cerebellopontine angles clear.

Intact. No fracture.

Minimal mucosal thickening in the right maxillary sinus, likely reflecting chronic change. Frontal, ethmoid, and sphenoid sinuses are clear.

Bilaterally well-aerated.

Globes and retro-orbital structures unremarkable.

Unremarkable.

1. No acute intracranial abnormality. No hemorrhage, mass, or large vessel territorial infarct to explain the patient's presentation. 2. Mild chronic microangiopathic white matter changes (Fazekas grade 1). 3. Minimal right maxillary sinus mucosal thickening, likely chronic. No follow-up needed. 4. Mild generalized cerebral volume loss, slightly advanced for stated age but nonspecific.

Hyponatremia-related cerebral edema, if present, may not be reliably detected on non-contrast CT. Clinical correlation and serial sodium monitoring recommended.