72-year-old male patient with gait difficulty. Evaluate for cerebral ischemia. There is no diffusion diffusion abnormality to suggest acute infarct. Again seen is encephalomalacia with adjacent increased T2 signal involving the right occipital and posterior temporal lobes from remote infarct. There is associated susceptibility effect consistent with chronic blood products associated with the prior infarct. Patchy foci of T2 signal hyperintensity in the periventricular white matter and in the pons is compatible with chronic small vessel ischemic disease. Mild prominence of the ventricles and sulci likely from age-related atrophy.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
1.No evidence of acute infarct, hemorrhage, or mass effect.2.Chronic right temporal occipital infarct and chronic small vessel ischemic disease similar to prior.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.