89 years Female (DOB:12/14/1926)Reason: r/o malignancy, stroke History: clinical appearance of seizures, likely renal malignancyPROVIDER/ATTENDING NAME: MICHELLE K MARTINCHEK MICHELLE K MARTINCHEK There are patchy foci of diffusion restriction present along the left cingulate gyrus and left corpus callosum anteriorly. Additional patchy foci of diffusion restriction are present along the left superior frontal gyrus posteriorly and the left paracentral lobule. In general there is no significant mass effect associated with this is only a relatively small portion of the anterior cerebral artery territories involved. These are also hyperintense on T2 and FLAIR MRI.A punctate focus of T2 and FLAIR signal hyperintensities present in the left thalamus. Some scattered foci of T2 and FLAIR signal hyperintensity are present in the brainstem.There are multiple punctate foci of loss of signal on susceptibility weighted image imaging is scattered throughout the subcortical white matter but also in the right basal ganglia, left thalamus and brainstem.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. The distal left anterior cerebral artery flow void is loss at approximately the level of the genu of the corpus callosum (a3 segment)The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.Patchy and small to medium sized subacute cerebral infarction the territory of the left anterior cerebral artery. There is no significant mass effect associated with it.2.Periventricular and subcortical white matter lesions of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.Multiple microhemorrhages are present within the brain parenchyma. Differential considerations include hypertension, amyloid angiopathy or both.