Acute PCA infarct
Blurred vision and confusion.
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Hypoattenuation in the left occipital lobe with loss of grey-white differentiation and positive mass effect (local sulcal effacement and mild compression of the trigone of the lateral ventricle) in keeping with an acute infarct in the PCA territory. Old infarcts within the right occipital lobe and right frontal lobe with encephalomalacia and negative mass effect.
This case gives a nice example of acute vs chronic infarction on CT. Note how the acute left occipital lobe infarct has positive mass effect, loss of grey-white differentiation and hypoattenuation which is not a low density as CSF, while the chronic infarcts on the right have negative mass effect and hypoattenuation that is approaching that of CSF.