Transient alteration of awareness, altered mental status, evaluate for stroke. MRI HEAD: Examination is significantly limited secondary to motion artifact. Numerous punctate foci of diffusion restriction are demonstrated predominantly in the bilateral frontal lobes with a few punctate foci present in the bilateral parietal lobes well. Additionally, there are punctate foci of diffusion restriction involving the basal ganglia. Extensive patchy and nodular areas of T2/FLAIR hyperintensity are demonstrated in the periventricular and subcortical white matter, most prominent at the frontal lobes. No midline shift or mass effect is appreciated.MRA HEAD: The internal carotid arteries are unremarkable. The bilateral middle and anterior cerebral arteries appear unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries appear grossly unremarkable.
1. Numerous punctate foci of acute ischemia predominantly involving the frontal lobes, basal ganglia, and to a lesser degree the parietal lobes.2. Extensive patchy and nodular areas of T2/FLAIR hyperintensity involving the periventricular and subcortical white matter may be related to chronic vascular ischemic change.3. Unremarkable MRA of the head.