Diagnosis: Other disturbances of skin sensation. Other symptoms and signs involving the musculoskeletal system HyperesthesiaClinical question: Evaluate for new acute or subacute stroke.Signs and Symptoms: Sudden onset of left facial and shoulder numbness, left arm weakness and hyperesthesia left face and arm. There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are stable since the prior examThere is a moderate degree of punctate hyperintense lesions within the brainstem, thalami, basal ganglia and deep cerebellar structures on the FLAIR and T2 images. There are a few more on this exam compared to the prior.There are multiple punctate SWI hypointense foci in the pons, thalami, basal ganglia and hippocampi which have accumulated further since the prior exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The left eye lens is thin.
1.Multiple microhemorrhages within the basal ganglia, medial temporal lobes, thalami and brainstem have mildly increased since the prior exam. The pattern suggest hypertension related microhemorrhages.2.Multiple lesions in the brainstem, thalami and basal ganglia have slightly increased since the prior exam. At this age they are most likely vascular related. 3.Periventricular and subcortical white matter lesions of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. 4.No evidence for acute ischemic cerebral infarction.