65 years Male (DOB:7/7/1951)Reason: eval for stroke History: R facial droop, R hip flexor weakness and RLE numbness x3 weeksPROVIDER/ATTENDING NAME: JEFFREY T JACOBS JEFFREY T JACOBS A focus of diffusion restriction is present in the left thalamus and another one in the left cerebral peduncle. This associated with T2 and FLAIR hyperintensity.There is a moderate to marked degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images as well as to a lesser degree similar lesions in the brainstem and cerebellum. Small uptake T2 and FLAIR hyperintense lesions are also present in the basal ganglia and thalami..Normal 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 demonstrate some mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Findings are compatible with acute lacunar infarcts involving the left thalamus and left cerebral peduncle.2.Findings are compatible with old lacunar infarcts in the thalami and basal ganglia.3.Periventricular and subcortical white matter lesions of a moderate to marked degree as well as some lesions in the brainstem and cerebellum are nonspecific. At this age they are most likely vascular related. 