45 years Male (DOB:5/23/1971)Reason: assessment for cause of dysarthria; further evaluation of punctate hypodensity in R thalamus on CT wo History: dysarthria after induction chemotherapy for AML (high dose cytarabine and mitoxantrone)PROVIDER/ATTENDING NAME: OLATOYOSI M ODENIKE There are punctate foci of signal loss and susceptibility weighted imaging left orbital gyrus, in the left inferior frontal gyrus as well as in the left frontal centrum semiovale. Additional punctate foci of signal loss and susceptibility imaging are present within the left cerebellar hemisphere.No abnormal enhancing mass lesions are appreciated within the brain parenchyma.The cerebellar tonsils extend 4 mm below the level of foramen magnum.The punctate hypodensity in the right thalamus and the CT scan probably represents a tiny perivascular space. It is bright on T2 imaging and dark on FLAIRNormal 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 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 right parotid gland extends into the buccal region. The left parotid gland is not identified on this exam it the exception of an accessory component of the left buccal tissues. Deep lobes of the parotid glands are not identified.
1.There are several microhemorrhages present in the left frontal lobe and the left cerebellar hemisphere. These are nonspecific. One possibility is that this is related to prior trauma though it is nonspecific related to other pathology.2.The punctate hypodensity in the right thalamus and the CT scan probably represents a tiny perivascular space3.No evidence for acute ischemic cerebral infarction.4.Low-lying cerebellar tonsils are borderline for Chiari I malformation.5.The parotid glands appear to be small and hypoplastic.