 MRI brain: There are multiple small foci of restricted diffusion in the right parietal lobe mostly along the postcentral gyrus and superior parietal lobule with associated T2 signal abnormality consistent with early subacute infarcts. There is a linear foci of restricted diffusion with associated T2 signal in the posterior aspect of the middle frontal gyrus involving the left frontal lobe. There are no associated enhancement. There are scattered foci of susceptibility in the left parietal, left frontal, left cerebellum and perhaps a tiny focus in the right cerebellum due to hemosiderin staining from prior hemorrhage.There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes. There are chronic lacunar infarcts in the left posterior frontal lobe, right parietal lobe and in the bilateral cerebellar hemispheres. Ventricles and sulci are mildly prominent, consistent with mild age-related volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of pathological enhancement. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.MRI of the spinal cord: The study is limited due to patient motion and scoliotic curvature of the spine. Also, this is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. The vertebral bodies are appropriate in the overall alignment and height. The spinal cord has normal signal characteristics and overall morphology. There is no compromise of the spinal cord.There are mild scattered spondylotic changes in the cervical spine, most conspicuous at C4-C5 and C5-C6. In the lumbar spine, there is disc bulge at L4-L5.Subsegmental atelectatic changes in the right lung base posteriorly.
1. Several small foci of restricted diffusion with associated T2/FLAIR signal in the right parietal lobe mostly along the postcentral gyrus and superior parietal lobule consistent with early subacute infarcts. Additional focus of subacute infarct in the left frontal lobe.2. Chronic lacunar infarcts in the left posterior frontal lobe, right parietal lobe and in the bilateral cerebellar hemispheres. Mild chronic small vessel ischemic disease.3. No evidence of metastatic lesions in the brain parenchyma.4. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.