Weakness [R53.1], Reason for Study: ^Reason: rule out new ischemia History: L sided weakness and hypoesthesia Brain MRIThere is no evidence of acute ischemic infarct.Multifocal susceptibility lesions on bilateral hemisphere are seen. These lesions may reflect chronic microhemorrhages or mineralizations.Multiple small lacunar infarcts are seen on bilateral thalami as well as is a ganglia.Wedge-shaped tissue defect on the left cerebellar hemisphere indicate chronic ischemic infarct.There are patchy and somewhat confluent T2/FLAIR high signal intensity lesions on periventricular white matter indicate nonspecific small vessel ischemic disease. The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate some luminal irregularities of the bilateral MCA branches. However, overall, bilateral ICAs, MCAs and ACAs and vertebrobasilar system appear to be normal.
1. No evidence of acute ischemic lesion.2. Multifocal susceptibility lesions on bilateral hemisphere without associated surrounding edema indicate chronic hemorrhages or mineralizations.3. Multiple infarcts with tissue loss involving bilateral thalami, basal ganglia, corpus callosum and left cerebellar hemisphere.4. Nonspecific small vessel ischemic disease.5. Normal brain MRA 