Left sided weakness initially, followed by incontinence and LOC. Many of the images are degraded by patient motion.MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are subcentimeter defects in the bilateral thalami. There is mild supratentorial and infratentorial white matter T2 hyperintensity. There is no definite abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are secretions in the right posterior ethmoid sinus. There is a defect in the right medial orbital wall with herniation of the orbital fat and deformity of the medial rectus muscle. There is a subcentimeter right frontal scalp lipoma.MRA: There is mild stenosis of the right middle cerebral artery. The other major cerebral arteries appear to be patent. There is no evidence of cerebral aneurysms.
1. Chronic lacunar infarcts in the thalami and mild small vessel ischemic disease, but no evidence of intracranial hemorrhage, mass, or cerebral edema.2. Mild stenosis of the right middle cerebral artery.3. Chronic right medial orbital wall fracture.