Male, 71 years old, with altered mental status. Assess for stroke. A 4 mm focus of mildly restricted diffusion is seen within the white matter adjacent to the left ventricular atrium. A similar lesion was seen on the prior examination at 6/18/2015 but is now reduced in signal intensity. No other definite diffusion restricting lesions are seen.Motion artifact substantially degrades image quality on most of the other sequences. Mild patchy foci of T2 hyperintensity are evident within the cerebral white matter and the pons. Scattered foci of susceptibility are also evident, the largest of which are within the inferior aspect of the right postcentral gyrus, stable, and along the right basal ganglia, possibly new.Postcontrast images are degraded, but no definite pathologic intracranial enhancement is seen.Thin bilateral subdural collections are evident along the cerebral hemispheres demonstrating T2 hyperintense and T1 isointense signal. These collections are symmetric bilaterally and measure no more than 3 mm in thickness. They exert no significant mass effect upon the brain.The ventricles and sulci are stable in caliber relative to the prior exam.
1.Small evolving late subacute small vessel stroke within the left periatrial white matter.2.Evidence of chronic small vessel ischemic disease and scattered microhemorrhage.3.Interval development of small symmetric bilateral subdural collections which could represent very small subdural hemorrhages or nonhemorrhagic effusions. These exert no significant mass effect upon the brain. Imaging follow-up is suggested to document resolution.