80 year-old female with left PCA the and left PICA infarctions and possible occluded left vertebral artery. Evaluate for structural changes. There is no evidence of intracranial hemorrhage, mass, extra-axial fluid collection or midline shift. An area of hyperdensity is noted within the left medial temporal lobe. Additionally areas of hypodensity are noted within the left thalamus, the left superior medial cerebellum and the left occipital lobe. There is no volume loss or effacement of the sulci. These findings are consistent with the patient's history of stroke. Additionally, there are multiple areas of hypodensity within the periventricular and deep white matter which are compatible with the MRI findings of chronic small vessel disease.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses are normally pneumatized. There is minimal opacification of the mastoid air cells. Vascular calcifications of the internal carotid and vertebral arteries bilaterally.
Findings consistent with known stroke involving the left medial temporal lobe, left thalamus, left superior medial cerebellum, and the left occipital lobe. There is no mass effect, midline shift, or evidence of hemorrhagic conversion. These findings appear stable since the previous MRI examination on 10/24/2011.