Bilateral basal small flaky hypodense shadows are CT head findings that indicate the presence of possible ischemic changes in the area. Bilateral basal small patchy hypodense shadow is the image description, found by head CT examination, mainly suggests the existence of ischemic changes, the most common cause for atherosclerosis, mainly in the elderly, mostly with hypertension, diabetes mellitus, hyperlipidemia and other cerebral atherosclerosis-related diseases. Ischemic changes are also seen in other causes, such as carbon monoxide poisoning, drug intoxication, and central nervous system demyelinating diseases, etc. Therefore, further cranial magnetic resonance examination is sometimes needed to further define the cause of ischemia. If the examination reveals small flaky hypodense shadows in the bilateral fundus, it is recommended to consult a doctor for further treatment under the guidance of a physician.