Clinical question: Repeat study, given motion artifact with prior study, persistent altered mental status for unknown reasons. Signs and symptoms: As above. Nonenhanced brain MRI:Diffusion-weighted images demonstrate a tiny focus of restricted diffusion in the left centrum semiovale measuring approximately 5 mm sized. There is no evidence of hemorrhage in this finding. This finding was also utilized flair sequence as a small focus of hyperintensity.Examination condition demonstrate minimal periventricular white matter flair hyperintensity and a tiny focus of similar signal change in the left external capsule which are suspicious for minute chronic non-hemorrhagic small vessel ischemic strokes.The anatomical morphology as well as the signal intensity of brain parenchyma otherwise remains within normal all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits and paranasal sinuses.
1.5-mm focus of restricted diffusion in the left centrum semiovale noted on diffusion-weighted images.2.Minute chronic nonhemorrhagic small vessel ischemic strokes as detailed.3.Unremarkable exam otherwise.