74 years Male (DOB:7/5/1942)Reason: asses for ischemia/CVA History: right sided weakness, slurred speechPROVIDER/ATTENDING NAME: ROBERT A MULLIKEN There is a focus of diffusion restriction present left centrum semiovale extending to the adjacent left basal ganglia measuring 20 x 13 mm axial dimensions. This is associated T2 and flair hyperintensitySmall foci of T2 and FLAIR signal hyperintensity are present in the right and left basal ganglia as well as the right thalamus and in the brainstem.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Findings compatible with a small subacute infarction involving the left centrum semiovale. There is no evidence for hemorrhagic conversion at this time.2.Small lesions in the brainstem, basal ganglia and thalami are suspected represent lacunar infarcts in the chronic stage with the exception of the above described lesion.3.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 