History of CVA and cognitive impairment. There is no evidence of restricted diffusion to suggest acute ischemia. Again seen is encephalomalacia involving the right occipital lobe with associated ex vacuo dilatation of the right atrium and occipital horn. There are multiple areas of chronic infarcts in the bilateral cerebellum, right thalamus, unchanged. There is bilateral cerebral periventricular white matter T2/FLAIR hyperintense lesion most likely, related to chronic small vessel ischemic changes. There is partial volume loss at the level of left caudate head, unchanged. There are several foci of susceptibility in the region of right occipital lobe encephalomalacia related to chronic microhemorrhage.There is no abnormal intracranial enhancement. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild mucosal thickening in the left more than the right ethmoid sinus and the left frontal sinus.
1. No evidence of acute ischemia.2. Stable encephalomalacia in the right occipital lobe, chronic infarcts in the bilateral cerebellum and right thalamus, mostly along the posterior circulation. 3. Moderate chronic small vessel ischemic changes and chronic infarct in the head of caudate nucleus, unchanged.