 There is mild restricted diffusion predominantly involving the inferior cerebellar vermis on the right with also a punctate focus in the right inferior cerebellar hemisphere with slight evolution since outside MRI. No findings to suggest new infarct. There is T2/FLAIR hyperintensity associated with the cerebellar infarcts consistent with mild edema. There is a punctate focus of susceptibility in the right inferior cerebellum which may represent a microhemorrhage versus thrombus within a branch vessel, and also present on outside study.Remainder of the brain parenchyma is unremarkable. No intracranial mass or mass effect. No midline shift or herniation. Ventricles and sulci are within normal limits. Calvarium and intracranial soft tissue is unremarkable.MRA HEAD
1. Slight interval evolution of recent infarcts involving the right inferior cerebellar vermis and right cerebellar hemisphere. No new infarct.2. Dissection of the right vertebral artery primarily involving the V2 segment with near occlusion and milder irregularity and narrowing involving the right V3 segment. The intracranial right vertebral artery is small but this is nonspecific and favored to be developmental. Dominant left vertebral artery, basilar artery and remainder of the intracranial circulation appear patent.3. Punctate focus of susceptibility in the right inferior cerebellum which may represent a microhemorrhage or perhaps thrombosis within a branch vessel but unchanged.