Altered mental status, worsening left-sided weakness, rule out new ischemic stroke. There is no restricted diffusion to suggest acute ischemia. There is scattered punctate and confluent T2/FLAIR hyperintensity in the bilateral supratentorial subcortical and periventricular white matter which are nonspecific, but most likely related to chronic small vessel ischemic changes. There is mild global parenchymal volume loss. There is a punctate focus of susceptibility in the left frontal lobe white matter, likely related to chronic hemorrhage. There is no pathological enhancement. No evidence of intracranial mass effect, midline shift, or herniation. No hydrocephalus. No extra-axial collections. Calvarium and extra cranial soft tissues are grossly unremarkable.
1. No evidence of acute ischemia. 2. Bilateral cerebral white matter hypoattenuation foci are nonspecific but compatible with chronic small vessel ischemic changes.3. Nonspecific punctate focus of susceptibility in the left frontal lobe, related to chronic hemorrhage.