Stroke and altered mental status. Motion degrades some sequences. Within the posterior left thalamus, there is a lesion with intrinsic T1 hyperintensity and T2 hyperintensity and a peripheral rim of susceptibility measuring up to 19 mm. There is minimal mass effect associated with this lesion. There are small areas of encephalomalacia in the left pons, left cerebellar hemisphere, bilateral precentral gyri, and bilateral parietal lobes. There is encephalomalacia with hemosiderin deposition in the left supramarginal gyrus region, as well as in the right middle frontal gyrus and the right superior frontal gyrus. There is a background of scattered periventricular and subcortical white matter T2 hyperintensity. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.A lesion measuring up to 19 mm in the left posterior thalamus may represent a subacute hemorrhagic infarct, but no evidence of acute infarction. 2.Extensive probable chronic small vessel ischemic white matter disease and multiple foci of chronic infarcts, some of which also demonstrate chronic hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.