 There is a small focus of increased diffusion signal on series 3 image 18 in the right hemipons with focally decreased ADC signal. This area shows very subtle abnormal T2 signal abnormality. There is mild nonspecific T2 hyperintense signal abnormality in the periventricular and subcortical white matter, as well as the brainstem likely representing chronic microvascular ischemic changes. There is mild global volume loss commensurate with patient age with bilateral hippocampal volume loss (right greater than left), and slightly greater volume loss in the right temporal lobe. There is no hydrocephalus. There is no midline shift or herniation. The left V3 vertebral artery flow void is diminutive suggesting stenosis vs hypoplasia. There is a small left maxillary sinus air-fluid level with trace bilateral mastoid mucosal thickening. The skull and extracranial soft tissues are unremarkable.
1.Small recent (acute/subacute) right hemipontine infarct.2.Mild global parenchymal volume loss with slightly greater involvement of the right temporal lobe and right hippocampus. 3.Mild chronic microvascular ischemic changes.The finding regarding infarct was discussed with Dr. Emma Daisy over the telephone at 3:19 p.m. today.