Dysphagia, unspecified for 2 years, recurrent episodes of left-sided numbness of face, arm, leg. Rule out ischemic lesion of right side of cerebrum or brainstem. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild scattered cerebral white matter T2 hyperintensities, which are nonspecific and unchanged. There is also a fine linear area of T2 hyperintensity in the medial left cerebellar hemisphere. The brainstem appears to be unremarkable. There is a partially empty sella. There is diffuse cerebral volume loss, which appears to be slightly more pronounced than in 2013. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No evidence of acute ischemia or acute intracranial hemorrhage.2. Scattered punctate and periventricular white matter T2 hyperintensities are nonspecific, but may relate to chronic small vessel ischemic disease.3. A fine linear area of T2 hyperintensity in the medial left cerebellar hemisphere may represent a chronic lacunar infarct. 4. Diffuse cerebral volume loss, which appears to have progressed since 2013.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.