 BRAIN: There is an approximately 1 cm focus of restricted diffusion in the region of the left posterior limb of the internal capsule and lateral left thalamus with associated increased T2 signal compatible with an acute ischemic infarction. No additional foci of restricted diffusion are identified. There are several punctate and confluent foci of increased T2/FLAIR signal within the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Incidental note is made of a partially empty sella. There is redemonstration of a chronic right lamina papyracea fracture.MRA HEAD: The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.
1.Small, acute lacunar infarct within the region of the left lateral thalamus/posterior horn of the left internal capsule.2.Mild chronic small vessel ischemic changes.3.MRA without intracranial aneurysm or significant stenosis.Discussed with FINTEL, BARA at 12:48 on 8/29/2015. 