77-year-old woman with history of left lower extremity weakness, evaluate for acute stroke. Scattered areas of diffusion restriction along the medial aspect of the right superior frontal gyrus with the most conspicuous area in the right precentral gyrus. Additional scattered punctate foci are seen along the cingulate gyrus as well as along the right body of the corpus callosum. Findings are along the right anterior cerebral artery territory. There is associated increased T2 signal best seen on the FLAIR sequence. There is no significant mass effect, midline shift, or herniation.Additional foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with moderate chronic small vessel ischemic changes. The left caudate head is atrophic with decreased T2 signal suggestive of hemosiderin deposition. Increased T2 signal is seen in the genu of the left internal capsule. There is no intracranial mass or mass-effect. There is ex vacuo dilatation of the left lateral ventricle, otherwise the ventricles are within normal limits in size and configuration. The major flow-voids are preserved.The patient has had left cataract surgery. Bone marrow signal and extracranial soft tissues are within normal limits.
1.Scattered acute right anterior cerebral artery territory punctate infarcts. 2.Chronic left caudate infarct with additional moderate chronic small vessel ischemic changes.3.Incomplete examination as the patient was unable to tolerate the entire examination. There will be attempt to obtain susceptibility weighted and MRA sequences on a repeat study today.