Altered mental status, Due to patient's motion, the MR examination was prematurely stopped thus this examination does not include gradient echo scans.Subtle restricted diffusion on the right thalamus as well as involving posterior limb of right internal capsule is seen which may indicate subacute ischemic infarction. Since there is no gradient echo scans, possibility of focal hemorrhagic transformation cannot be evaluated. There is another high signal intensity lesion on the left lateral ventricle occipital horn on the diffusion weighted image which again shows subtle diffusion restriction as well as subtle high signal intensity on T2 weighted image. This lesion also may represent subacute ischemic infarction.There are focal small tissue losses on the bilateral basal ganglia and left centrum semiovale indicate multifocal chronic lacunar infarcts.Scattered high signal intensity lesions on bilateral trigone area as well as lower pons may indicate nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Subacute ischemic infarction on the right thalamus and periventricular white matter around the left lateral ventricle occipital horn as described above.2. Multifocal chronic ischemic lacunar infarctions and non specific small vessel ischemic disease as described above.3. No MR evidence of PRES.