Status post hypertensive stroke on xarelto. Examination is motion degraded. There is restricted diffusion involving the right posterior corona radiata extending into the posterior aspect of the right caudate body. There is corresponding hypodensity on CT from 1/24/2015 and minimal in this location on CT from 1/20/2015.Again seen is intraparenchymal hemorrhage involving the right caudate tail, adjacent periventricular white matter, and with intraventricular extension. Unchanged caliber of the ventricular system with right lateral ventricles larger than the left without evidence of hydrocephalus.Tiny focus of susceptibility is seen in the dorsal pons suspected to represent a chronic microhemorrhage, less likely vessel. Few scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Acute infarct involving the right posterior caudate and corona radiata/periventricular white matter. Serial CT demonstrates developing hypodensity in this location between CT 1/20 and 1/24/2015.2. Unchanged adjacent intraparenchymal hemorrhage with intraventricular extension.3. Examination is motion degraded. There is a probable chronic microhemorrhage focus in the pons. No other foci of chronic hemorrhage or intracranial masses are appreciated. 4. Mild chronic small vessel ischemic changes.