Dizziness and giddiness [R42], Reason for Study: ^Reason: Evaluate for new stroke History: Multiple episodes of lightheadedness w behavioral change, loss of bowels. History of stroke and TIA There is a small focus of diffusion restriction in the left peritrigonal white matter. There is prominence of the cortical sulci in proportion to cerebral ventricles consistent with global volume loss. There are numerous foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter. Several scattered lacunar infarcts are demonstrated in the bilateral centrum semiovale. There is a punctate focus of gradient susceptibility in the left thalamus likely relating to mineralization or chronic hemosiderin deposition. No midline shift or mass effect is appreciated. No intracranial fluid collections are visualized.
1. There is a punctate area of acute ischemia in the left peritrigonal white matter.2. Global volume loss and white matter changes consistent with advanced small vessel ischemic disease, progressed since 3/7/2010.