Acute mental status change and focal neurologic deficits, left upper extremity greater than right upper extremity. Several sequences are degraded by motion.There is a punctate focus of apparent mild diffusion restriction within the anterior medulla (series 406, image 48). Otherwise, no evidence of territorially restricted diffusion.Prominence of the ventricles and cortical sulci is compatible with mild parenchymal volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There is minimally increased T2/FLAIR signal within the periventricular white matter which is nonspecific. There is curvilinear focus of susceptibility artifact along the anterior left superior frontal sulcus with associated questionably increased FLAIR signal as well as questionable isointense material seen on recent CT which could reflect a trace amount of subarachnoid hemorrhage. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is mild mucosal thickening within the paranasal sinuses as well as small mucous retention cysts within the maxillary sinuses. There is near complete opacification of the bilateral mastoid air cells, middle ear cavities, and right greater than left petrous apices. There is nonspecific asymmetric, subtly increased FLAIR signal within the left lateral suboccipital subcutaneous soft tissues. There is diffusely decreased signal within the visualized osseous structures corresponding to diffuse sclerosis seen on CT.
1.Punctate focus of restricted diffusion in the anterior medulla which could be artifactual or a tiny acute ischemic infarction, correlate with clinical symptoms.2.Sulcal abnormality perhaps representing trace amount of subarachnoid hemorrhage along the left superior frontal sulcus, correlate with history of trauma.3.Nonspecific opacification of the bilateral mastoid air cells, middle ears, and petrous apices, correlate for otomastoiditis.4.Soft tissue edema within the left lateral suboccipital subcutaneous soft tissues which may simply reflect dependent edema, but recommend correlation with clinical examination to exclude soft tissue infection.5.Diffuse abnormal signal throughout the osseous structures corresponding to diffuse sclerosis on recent CT, which is nonspecific but may be metabolic.6.Minimal nonspecific increased T2/FLAIR signal within the periventricular white matter.