Altered mental status There is a focal restricted diffusion on the right deep parietal white matter indicating small ischemic infarct.There is no evidence of acute hemorrhage lesion.On FLAIR images, patch bilateral periventricular white matter high signal intensity lesions with a some scattered white matter high signal intensities indicate nonspecific small vessel ischemic disease.There is focal volume loss with surrounding patch high signal intensity on FLAIR on the left mesial aspect of cerebellar hemisphere indicate chronic ischemic infarct.Previously shown restricted diffusion lesions show focal increased signal intensity lesions on FLAIR imaging, however, do not show evidence of restricted diffusion anymore indicating chronic ischemic infarct.The ventricles, sulci and cisterns are symmetric and unremarkable. 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. A new focal restricted diffusion on the right deep parietal lobe white matter indicating focal acute ischemic infarct without hemorrhagic transformation.2. Moderate degree nonspecific small vessel ischemic disease, no change since prior exam.