Altered mental status, unspecified [R41.82], Reason for Study: ^Reason: stroke, seizures History: 82Yrs female with h/o above p/w possible first time sz? There is no evidence of acute ischemic or hemorrhagic lesion.Tissue loss with corresponding ventricular enlargement on the right hemisphere involving right basal ganglia, right thalamus, right frontal, temporal and somewhat parietal lobe with evidence of susceptibility lesions indicating hemosiderin deposition. Patchy FLAIR high signal intensity on bilateral periventricular white matter indicating nonspecific small vessel ischemic lesion.There is no mass, mass effect, edema, midline shift, or restricted diffusion/acute ischemia. 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. Right hemispheric extensive encephalomalacia with ex vacuo changes of the right lateral ventricle as described above with hemosiderin deposition indicating prior hemorrhagic infarction.2. No evidence of acute ischemic or hemorrhagic lesion. 3. Minimal non specific small vessel ischemic disease.