Possible new stroke. There is restricted diffusion on the mid pons left side (series #4, image #10/64) indicating perforator infarct.There is no evidence of hemorrhagic conversion.There is a focal tissue loss on the left thalamus and basal ganglia especially around the left side internal capsule posterior limb extended to the left periventricular white matter indicate prior lacunar infarct.Multifocal patch high signal intensities on periventricular white matter on FLAIR images indicate nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Acute ischemic infarct, likely represent perforator infarct on the left side of mid Pons without evidence of hemorrhagic transformation.2. Non specific small vessel ischemic disease as described above.