 MRI brain:Please note some of the sequences are highly motion degraded. There is restricted diffusion in the left middle frontal gyrus consistent with acute to early subacute infarction. There is T2/FLAIR hyperintensity and encephalomalacia involving the right frontal lobe with mild ex vacuo dilatation of the frontal horn of the right lateral ventricle consistent with chronic infarction. There is a wedge-shaped area of encephalomalacia in the right cerebellum related to chronic infarct. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes. There is mild global parenchymal volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified.There is suspicion of a lobulated isointense T1 and iso to slightly hyperintense T2 weighted mass in the sella/suprasellar region which is incompletely imaged. Normal flow-voids are demonstrated in the major intracranial vascular structures. There is mucosal thickening in the left maxillary sinus. MRA head : This is a motion degraded exam. The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. There are bilateral small P-comm arteries. The vertebral arteries, basilar artery and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.
1. Small areas of restricted diffusion in the left frontal lobe compatible with acute to subacute ischemia.2. Chronic infarct in the right frontal lobe. Chronic infarct in the right cerebellar hemisphere.3. Mild degree of chronic small vessel ischemic disease. 4. A suprasellar/sellar mass is incompletely imaged. Further evaluation with dedicated contrast enhanced pituitary MRI is recommended.5. Motion degraded MRA exam. Within the limitation, no gross evidence of cerebrovascular occlusion or aneurysm.Findings were discussed with Dr Xial at 10:40 hrs on 12/23/2015.