Differential Diagnosis for Right Ganglionic Ill-Defined Small Area of Abnormal Hypodensity on CT Brain
- Single Most Likely Diagnosis
- Lacunar infarct: This is a common cause of small, ill-defined hypodense areas in the basal ganglia on CT scans, often resulting from occlusion of small penetrating arteries.
- Other Likely Diagnoses
- Chronic small vessel ischemic change: These changes are common in elderly patients and can appear as small, ill-defined hypodense areas in the basal ganglia due to chronic ischemia.
- Encephalomalacia: This refers to the softening or loss of brain tissue, which can appear as a hypodense area on CT scans, often resulting from previous trauma, infection, or ischemia.
- Perivascular space: Enlarged perivascular spaces can sometimes appear as small, ill-defined hypodense areas, particularly in the basal ganglia.
- Do Not Miss Diagnoses
- Brain metastasis: Although less common, a solitary metastasis can present as a small, ill-defined hypodense area, especially if there's a known history of cancer.
- Abscess: A small brain abscess can appear as a hypodense area with ill-defined borders, and it's crucial to consider this diagnosis due to its potential for severe consequences if not treated promptly.
- Cavernous malformation: These vascular malformations can sometimes appear as small, hypodense areas with calcifications and are important to identify due to their potential for hemorrhage.
- Rare Diagnoses
- Neurodegenerative diseases (e.g., multiple system atrophy, progressive supranuclear palsy): Certain neurodegenerative diseases can cause changes in the basal ganglia that might appear as small, ill-defined hypodense areas on CT scans.
- Inflammatory diseases (e.g., multiple sclerosis, acute disseminated encephalomyelitis): Although less common in the basal ganglia, inflammatory diseases can cause lesions that appear hypodense on CT scans.
- Mitochondrial disorders: Rare genetic disorders affecting mitochondrial function can lead to abnormalities in the brain, including the basal ganglia, which might appear as hypodense areas on imaging.