56 years, Female, left weakness and numbness presenting a stroke code status post TPA. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Multiple confluent areas and scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild to moderate chronic small vessel ischemic disease. There are also scattered foci of susceptibility compatible with chronic microhemorrhage including the right temporal lobe as well as along the left periatrial white matter. Major flow-voids are preserved. There is mild to moderate opacification throughout the paranasal sinuses including the anterior and posterior ethmoid air cells, left worse than right, as well as mild mucosal thickening involving the maxillary sinuses, left greater than right. There is also mild opacification of the mastoid air cells, left greater than right. There is deformity involving the right medial orbital wall compatible with remote blowout fracture, with medial herniation of fat and slight contour deformity involving the right medial rectus muscle.
1. No evidence of acute infarct.2. Scattered foci of T2/FLAIR hyperintensity in the white matter are nonspecific but compatible with mild to moderate chronic small vessel ischemic disease. There are also few scattered foci of chronic microhemorrhage in a nonspecific distribution.3. Chronic right medial orbital wall fracture.