Aphasia. There is a cluster of punctate foci of restricted diffusion and high T2 signal involving the left inferior frontal gyrus, Heschl gyrus, and superior temporal gyrus. There are otherwise scattered punctate foci of cerebral white matter T2 hyperintensity without restricted diffusion, which may represent chronic small vessel ischemic disease. There is no evidence of intracranial hemorrhage or mass. The brainstem and cerebellum appear unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There are bilateral maxillary sinus retention cysts.
Punctate acute posterior left peri-Sylvian sulcus infarcts, without evidence of hemorrhagic transformation.