 MRI Brain:There is a prominent area of restricted diffusion involving the posterior limb of the right internal capsule and right corona radiata compatible with an acute infarct. Encephalomalacia the left basal ganglia, left internal capsule and left centrum semiovale probably represents sequela of a previous stroke. There is additional periventricular and subcortical white matter T2/FLAIR hyperintensity which is nonspecific but likely related to chronic small vessel ischemic disease. Post-treatment changes are seen in the left globe secondary to prior retinal detachment. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild scattered paranasal sinus mucosal thickening.MRA Brain: Again demonstrated is narrowing of the bilateral cavernous ICAs secondary to atherosclerotic disease. Additional scattered atherosclerotic stenoses are visualized elsewhere, including the right MCA trifurcation, left proximal A1 segment and right P2/P3 segments. There is no evidence of aneurysm or vascular malformation. MRA Neck: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. There is no evidence of stenosis or occlusion.
Evidence of a recent ischemic infarct involving the right internal capsule and right corona radiata. No evidence of hemorrhagic conversion, midline shift, or herniation.Encephalomalacia involving the left basal ganglia/IC and left anterior centrum semiovale related to chronic infarction.Underlying mild chronic small vessel ischemic disease.Atherosclerotic narrowing of the cavernous portions of the ICAs similar to previously. Additional scattered atherosclerotic stenoses are visualized elsewhere in the intracranial circulation. No evidence of significant steno-occlusive vascular disease in the neck. 