Possible right facial droop. There is a punctate focus of restricted diffusion in the superior left precentral gyrus. There is no evidence of intrcranial mass or acute infarct. There is mild cerebral white matter T2 hyperintensity predominantly in the periventricular regions, which may represent chronic small vessel ischemic disease. There is also a focal subcentimeter defect in the right thalamus. 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. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is minimal fluid signal within the mastoid air cells bilaterally. Deformity of the nasal skeleton is better depicted on the prior CT.
1. A punctate focus of restricted diffusion in the superior left precentral gyrus is nonspecific, but may represent a chronic microhemorrhage.2. Probable chronic mild small vessel ischemic disease and a chronic right thalamus lacunar infarct, but no evidence of acute cerebral infarction or mass.