 MRI of the brainThere are 2 subcentimeter foci of diffusion restriction present in the right precentral gyrus along its lateral aspect. These display some contrast enhancement.There are punctate foci of signal loss on susceptibility imaging. One located in the right temporal lobe subcortical white matter and one in the right basal ganglia and another located in the right occipital lobe subcortical white matter while another couple are located along the left superior frontal gyrus left and right orbital gyri as well as the left temporal lobe.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. 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.A couple small nodules adjacent to the parotid gland probably represent lymph nodes.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. The posterior communicating arteries are intact. The vertebral arteries are similar in size.MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.
1.Foci of diffusion restriction are present in the right precentral gyrus laterally compatible with subacute foci of infarction.2.There multiple subcortical punctate foci of susceptibility effect which correspond to calcifications on a CT of the head. They are nonspecific suggestive of cysticercosis in the appropriate clinical setting. Please note that punctate calcifications can also be seen with other entities as well3.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related.