Transient alteration of awareness [R40.4], Reason for Study: ^Reason: eval for CVA , mets History: acute mental status change There is a focal area of restricted diffusion on the right side of the midbrain without evidence of focal hemorrhage indicating acute ischemic infarct.Scattered bilateral T2/flair high signal intensity lesions on periventricular white matter indicate nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Focal acute ischemic infarction on the right side of midbrain without evidence of hemorrhagic conversion.2. Non specific small vessel ischemic disease.