Syncope. The left parieto-occipital region intraparenchymal hematoma from January 2016 has resolved, leaving encephalomalacia and hemosiderin staining at the site, and there is no evidence of acute infarction or mass. There is diffuse patchy cerebral and pontine white matter T2 hyperintensity and a punctate focus of encephalomalacia in the right thalamus. There is a punctate focus of susceptibility effect in the left cerebellar hemisphere, which may represent a chronic lacunar infarct. There is a small developmental venous anomaly in the right cerebellar hemisphere. There is ex vacuo dilatation of the posterior left lateral ventricle superimposed upon mild diffuse cerebral volume loss. There is no midline shift or herniation. The orbits, skull, mastoid air cells, and scalp soft tissues are grossly unremarkable. There is a left maxillary sinus retention cyst.
1. Chronic right thalamus lacunar infarction and what likely represents chronic small vessel white matter ischemic disease, but no evidence of acute infarct. 2. The left parieto-occipital region intraparenchymal hematoma from January 2016 has resolved, leaving encephalomalacia and hemosiderin staining at the site.