Male, 79 years old, with altered mental status. A 5 mm focus of restricted diffusion is evident along the right single gyrus. No definite additional restricted diffusion is seen in the brain.Fairly extensive and nearly confluent periventricular T2 hyperintensity is seen. Scattered additional lesions are also evident more peripherally in the cerebral hemispheres and within the pons.No evidence of significant parenchymal edema or mass effect is detected. No abnormal extra-axial collections are seen. No acute intracranial hemorrhage is observed, though please note that susceptibility weighted images are degraded of the posterior fossa.MRA images of the head are degraded by motion artifact. Within this limitation, no significant stenosis or occlusion of the large proximal vessels is suspected. Some degree of narrowing may be present along the visualized left ACA branches, but this can also be technical.MRA images of the neck are similarly degraded, but again, no large or significant vascular stenosis is suspected. The right vertebral artery is dominant.
1.Small focus of acute ischemia along the right cingulate gyrus.2.Extensive chronic microvascular ischemic disease.3.No large or significant stenosis of the proximal circle of Willis vessels is seen. Examination is not reliable for the assessment of more distal or smaller vessels.4.No large or significant stenosis of the neck vessels is suspected.