 Again seen is restricted diffusion involving the posterior limb of the right internal capsule consistent with acute infarct, and similar to recent MRI from 2/22/2016. There is minimal interval increase in FLAIR hyperintensity associated with it, which is compatible with slight evolution. There is no evidence of a new infarct. No intracranial mass or mass effect. There are multiple areas of T2/FLAIR hyperintensity in the bilateral periventricular and subcortical white matter which are nonspecific but compatible with chronic small vessel ischemic disease, which is advanced for age. Small chronic cortical infarct in the right parietal lobe is also again noted. Chronic left pontine lacunar infarct also noted. Small chronic right lateral cerebellar hemisphere infarct also suspected. Scattered small foci of susceptibility are compatible with chronic microhemorrhages and involve the basal ganglia, thalami, and brainstem as before. No hemorrhage associated with the recent infarct is appreciated.MRA HEAD
1. Slight evolution of recent lacunar infarct involving the posterior limb of the right internal capsule. No new infarct or hemorrhagic transformation associated with this lesion. Additional findings including multiple chronic infarcts, as above, which are unchanged since prior.2. Mild to moderate multifocal stenosis involving the intracranial posterior circulation as described above. No large vessel occlusion. No significant arterial stenosis in the neck.