69 years Female (DOB:7/17/1947)Reason: stroke rule out History: stroke rule out with new onset AMSPROVIDER/ATTENDING NAME: KOUROSH D REZANIA KOUROSH D REZANIA MRI of the brainNo diffusion weighted abnormalities are appreciated.This a focus of encephalomalacia present in the right middle frontal gyrus associated with some gyral signal loss and susceptibility imaging. A similar focus is present in the left middle frontal gyrus.There is a mild degree of periventricular and subcortical confluent hyperintense white matter lesions present identified on the FLAIR and T2 images. Patchy T2 and FLAIR signal hyperintensities are present in the brainstem.No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.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 mild mucosal thickening in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Patient motion degrades some of the pulse sequence acquisitions.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The right vertebral artery appears to be hypoplastic.
1.No evidence for cerebrovascular occlusive disease. 2.No evidence for intracranial aneurysm..3.Findings suggest a small foci of encephalomalacia in the right and left middle frontal gyri. Most likely these are related to ischemic events.4.Periventricular and subcortical white matter lesions of a moderate degree are nonspecific. At this age they are most likely vascular related. Additional patchy lesions in the brainstem are also likely vascular related5.The exam is degraded due to patient motion which could excrete obscure some subtle abnormalities.6.There is no evidence for acute ischemic cerebral infarction.