Evaluate for stroke or other intracranial abnormality. Altered mental status and gaze deviation. History of endocarditis. The evaluation is limited by motion degradation. This is a punctate focus of what appears to be mildly restricted diffusion and high T2 signal within the left precentral gyrus and an additional punctate focus of what may be mildly restricted diffusion within the right cerebellum. There is no midline shift or herniation. There is no evidence of intracranial hemorrhage or mass. The brain parenchyma otherwise appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. The major cerebral flow voids are intact. The orbits, skull, pituitary gland, and scalp soft tissues are grossly unremarkable. There is mild scattered paranasal sinus mucosal thickening and secretions. There is fluid in the bilateral mastoid air cells.
1. Punctate lesions within the left precentral gyrus and within the right cerebellum, likely represent subacute ischemic infarcts related to emboli from endocarditis.2. Fluid in the bilateral mastoid air cells.Findings discussed with Dr. Khatibi at 946am on 10/19/2016.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.