Altered mental status [780.97], Reason for Study: ^Reason: evaluate for metastasis, stroke History: new left sided weakness, seizure No evidence of acute ischemic or hemorrhagic lesion.There are multifocal encephalomalacia including right parietal temporal occipital lobe, left occipital lobe and bilateral cerebellar hemisphere indicating chronic ischemic infarct. In addition, there are multiple lacunar infarcts involving bilateral thalami and basal ganglia.Underlying brain also shows patch high signal intensities on periventricular white matter on FLAIR imaging 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, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.2. No evidence of abnormal enhancement.3. Multifocal chronic ischemic infarct with the encephalomalacia seen.4. Moderate degree nonspecific small vessel ischemic disease.