Unspecified fall, initial encounter [W19.XXXA] / Neoplasm of unspecified behavior of brain [D49.6], Reason for Study: ^Reason: bilateral LE weakness, h/o of ependymoma in 2002 History: as above There is restricted diffusion on the right basal ganglia extends toward periventricular white matter with the focal susceptibility artifacts on the inferior aspect of the lesion indicating possible focal hemorrhagic conversion.Underlying brain shows evidence of left frontal craniotomy associated with underlying encephalomalacia of the left frontal lobe which likely represent postoperative changes.There are also patchy FLAIR/T2 high signal intensity lesions on bilateral periventricular white matter and centrum semiovale indicating nonspecific small vessel ischemic disease. Scattered chronic lacunar infarctions including right caudate head and left internal capsule, unchanged.There is no evidence of abnormal enhancement.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. 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. Right basal ganglia acute ischemic infarct with possible focal hemorrhagic conversion.2. Post left frontal craniotomy with associated postoperative changes of left frontal lobe. No unusual finding, unchanged since prior scan.3. Nonspecific small vessel ischemic disease and multifocal chronic lacunar infarctions, unchanged since prior scan.