Male, 74 years old, with vertigo. Concern for stroke. Small foci of restricted diffusion are seen within the right inferior cerebellar hemisphere and the right cerebellar tonsil. There is also a punctate focus of restricted diffusion within the medulla. No supratentorial restricted diffusion is seen.A chronic right cerebellar infarct is redemonstrated similar to prior. Scattered foci of periventricular T2 hyperintensity are also demonstrated appearing grossly similar to prior. No pathologic parenchymal or extra-axial enhancement is observed.No evidence of significant generalized mass effect is seen. No acute intracranial hemorrhage or any abnormal extra-axial fluid collections are detected. Ventricles are normal in size and morphology.Sequelae of sinonasal surgery are redemonstrated. Scattered paranasal sinus opacification appears similar to prior.The right vertebral artery is of small caliber and demonstrates only thready opacification through its cervical segments. The left vertebral artery is unremarkable. The carotid vessels are free of significant stenosis in the neck.
1.Small foci of restricted diffusion are seen within the right cerebellar tonsil, the right cerebellar hemisphere and the medulla. Findings were discussed with Dr. Bernard at 3:30 PM on 5/18/2016.2.In correlation, the right vertebral artery is of small caliber and demonstrates only thready opacification throughout its extent.3.A large chronic right PICA territory cerebellar infarct is unchanged.