Altered mental status, unspecified [R41.82], Reason for Study: ^Reason: meningitis History: encephalopathy Subtle focal restricted diffusion on the left side of the mid Pons unchanged since prior scan indicating acute ischemic infarct. There is no evidence of acute hemorrhagic lesion.There is evidence of tissue loss on the left basal ganglia thalamus as well as caudate head indicating prior ischemic infarct evidence of hemorrhage, unchanged.Patchy T2/flair high signal intensity lesions on bilateral periventricular white matter indicating small vessel ischemic disease, unchanged.There is no evidence of abnormal enhancement on the scan.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or abnormal contrast enhancement. 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. Left mid pontine acute ischemic infarct without evidence of hemorrhagic transformation, unchanged since prior scan.2. No evidence of acute hemorrhagic lesion. 3. No evidence of abnormal enhancement.3. Chronic ischemic lesion on the left basal ganglia, caudate head and thalamus with the tissue loss, unchanged since prior scan.4. Nonspecific small vessel ischemic disease, unchanged since prior scan.