Rt facial numbness x 4-5 days The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 10mmx18mm axial dimension gyriform focus of diffusion restriction along the left occipital lobe which partially involves primary visual cortex and partially higher level cortex.There is a subtle punctate focus of DWI signal hyperintensity in the lateral aspect of the left thalamus which is not identified on ADC maps.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.
1.There is a small subacute infarction along the left occipital lobe as described above.2.There is a punctate lesion in the left thalamus along its lateral aspect. It is possible that this also represents a punctate subacute cerebral infarct.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 