AMS, new onset right sided flaccid weakness. There is high T2 signal and restricted diffuse in the bilateral medial thalami, left midbrain, left occipital lobe and medial thalamus, right posterior insula ad temporal stem, and right frontal and parietal lobe. There is a subcentimeter area of high T2 signal in the right splenium of the corpus callosum without apparent restricted diffusion. There are small areas of encephalomalacia in the anterior right thalamus and midbrain. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are unchanged in size and configuration. There is a partially empty sella. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Multiple recent infarcts in the distribution of the artery of Percheron or top of the basilar, left posterior cerebral artery, and right middle cerebral artery territories, superimposed upon chronic infarcts of the right thalamus and midbrain.Discussed with Dr. Hornik at 3PM on 8/10/15.