Reason: Evaluate for ischemia History: LUE weakness, loss of vision in the L eye The CSF spaces are appropriate for the patient's stated age with no midline shift. 5-8 punctate foci of diffusion restriction are present between the right anterior, middle and posterior cerebral artery territories in the subcortical and periventricular white matter.On susceptibility imaging there is a punctate focus of signal loss present in the right inferior frontal gyrus. In isolation this is of unknown clinical significance.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Punctate foci of a cerebral infarction are present between vascular territories in the right cerebral hemisphere suggesting watershed distribution. Please correlate with a possible history of vascular stenosis in the right carotid distribution.2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 