48-year-old male patient with left arm numbness. Question of ischemia/infarction. MRI BRAIN: There are no diffusion-weighted abnormalities to suggest acute ischemia. An area of encephalomalacia within the inferior left parietal lobe is consistent with a chronic ischemic infarct. There is an area of cortical T2 signal abnormality with associated susceptibility artifact within the right posterior parietal lobe, which is new from the prior MRI and consistent with a chronic ischemic infarct. There is also cortical T1 signal hyperintensity in this region consistent with laminar necrosis. Additional scattered foci of subcortical and periventricular white matter T2 hyperintensity likely represents chronic small vessel ischemic disease. A focus of susceptibility artifact within the left parietal lobe is unchanged and likely represents old blood product.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA BRAIN:There is normal flow related signal within the distal bilateral vertebral arteries, within the basilar artery, distal bilateral internal carotid arteries and carotid siphons and bilateral anterior, middle and posterior cerebral arteries. No arterial stenoses, occlusions or aneurysms are identified.
1. No evidence of an acute ischemic infarct.2. Chronic left inferior parietal lobe ischemic infarct and a chronic ischemic infarct involving the posterior right parietal lobe, which is new from the prior MRI. These findings occur on a background of chronic small vessel ischemic disease.3. Unremarkable MRA of the brain. 