Dysarthria and anarthria [R47.1], Reason for Study: ^Reason: stroke? History: ataxia, unsteady gait No evidence of acute ischemic or hemorrhagic lesion.There are multifocal lacunar infarcts involving bilateral thalami, bilateral basal ganglia and bilateral periventricular white matter.Underlying brain also shows patchy high signal intensity lesions on FLAIR imaging especially on deep white matter and periventricular white matter indicating nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and 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. The distal left ICA shows high signal intensity rim within the arterial lumen indicating arterial wall thickening. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.Multifocal lacunar infarctions and non specific small vessel ischemic disease.2. Left distal ICA wall thickening was appreciated but the degree of stenosis cannot evaluated based on this scan.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.