Reason: mild aphasia prior CVA, please assess History: language problems, mild attentional problems The CSF spaces are appropriate for the patient's stated age with no midline shift. No diffusion restriction is appreciated.There are small foci of encephalomalacia present along the left middle and inferior frontal gyrus as well as a punctate lesion in the left hand motor area. There are associated tiny foci of SWI signal loss along the associated cortex.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.There is diffuse calvarial thickening. Marrow signal is diminished
1.There are small foci of encephalomalacia present in the left inferior and middle frontal gyri as well as a punctate focus in the left hand motor area. These most likely are related to a prior ischemic event.2.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They are most likely vascular related, however, they are nonspecific and can be seen with demyelination or vasculitis ,for example, depending on the clinical context. 3.Diffuse calvarial thickening is a nonspecific findings. Please correlate with the clinical history.4.There is no evidence for acute ischemic cerebral infarction. 5.Marrow signal is diminished which is non-specific. It could relate to chronic disease, anemia, myeloproliferative disorder, renal failure etc.