Altered mental status. Altered mental status. New left sided facial droop There is a punctate focus of diffusion restriction present in the right fusiform gyrus and another punctate focus of diffusion restriction in the right cerebellar hemisphere in the right posterior inferior cerebellar artery territory.There is a slitlike focus of the hyperintensity with a little bit of signal loss located in the right basal ganglia neostriatum. It is associated with some susceptibility artifact. There is associated volume loss.On susceptibility imaging are punctate foci of signal loss present in the brainstem, right thalamus and in the left periventricular white matterThere is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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. There appears to be fetal origin of the left posterior cerebral artery.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 exam is mildly degraded on some of the sequences due to patient motion.
1.There are a couple tiny foci of cerebral infarction present one in the right cerebellar hemisphere and another in the right fusiform gyrus.2.There is an old hemorrhagic lesion in the right basal ganglia.3.There is a mild degree of microhemorrhages in the brainstem and right thalamus. Most likely these are related to hypertension. Please correlate with clinical history.4.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 5.The exam is mildly degraded on some of the sequences due to patient motion.