Episodes of left sided weakness and occasional slurred speech. Family reports a stress test with triple vessel disease. Brain MRI: There is an area of high T2 signal and restricted diffusion in the right thalamocapsular junction that measures up to 25 mm. There is also a subcentimeter focus of high T2 signal and restricted diffusion in the right posterior putamen. There is no evidence of intracranial hemorrhage or mass. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Brain MRA: There is no evidence of significant steno-occlusive lesions or aneurysm.Neck MRA: There is no evidence of significant steno-occlusive lesions.
1. Acute infarcts in the right thalamocapsular junction and putamen without evidence hemorrhagic transformation or midline shift.2. No evidence of significant steno-occlusive disease in the major head and neck arteries, within the limits of MRA.Discussed with nurse Valerio at 5PM on 9/21/15.