Right lower facial droop and aphasia. MRI: There is extensive patchy T2 hyperintensity involving the cerebral and pontine white matter. There is no evidence of acute infarct. There is diffuse cerebral volume loss. There is no evidence of acute intracranial hemorrhage. There is no midline shift or mass effect. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.MRA: There is mild irregularity of the right cavernous internal carotid artery likely secondary to atherosclerotic calcifications. There is also mild focal narrowing of the P1-P2 junction of the right posterior cerebral artery. The rest of the major cerebral vessels are unremarkable. There is no evidence of cerebral aneurysms.
1. No evidence for acute ischemia.2. Cerebral and pontine white matter abnormalities may represent chronic small vessel ischemic disease.3. Mild irregularity of the right cavernous internal carotid artery likely secondary to atherosclerotic calcifications and mild focal narrowing of the P1-P2 junction of the right posterior cerebral artery, but no evidence of significant cerebral artery steno-occlusive disease otherwise.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.