 There is susceptibility artifact related to patient's partial dentures which limits assessment of the right inferior frontal lobe on the diffusion-weighted sequence. There is however no evidence of acute ischemia. There are patchy foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with moderate chronic small vessel ischemic disease. These changes are minimally worse since prior with, for example, interval increased T2 signal noted in the left parietal periventricular white matter.No intracranial mass or mass effect. Punctate focus of susceptibility consistent with chronic microhemorrhage in the left thalamus is again seen. The ventricles and sulci are within normal limits for patient's advanced age. Posterior fossa structures are grossly unremarkable. No extra-axial fluid collection is identified. Calvarium and extracranial soft tissues are grossly unremarkable.MRA HEAD
1. No evidence of acute infarct. Moderate chronic small vessel ischemic disease which is minimally worse since 3/24/2015. Brain parenchyma is otherwise unremarkable for age.2. No significant stenosis in the intracranial vasculature.3. 1 to 2 mm aneurysms involving the right A1-A2 junction and the right P1 segment. These findings are grossly unchanged since 3/24/2015.