History of CVA and CNS vasculitis, presenting with worsening right sided weakness. The images are generally degraded by patient motion. There is no evidence of acute infarction. There are numerous patchy areas of high T2 signal in the bilateral cerebellar hemispheres, right occipital lobe, left frontal lobe, bilateral basal ganglia, and subcortical and periventricular white matter. There is also encephalomalacia in the bilateral cerebellar hemispheres, right pons, and bilateral basal ganglia. There is unchanged susceptibility effect within the bilateral basal ganglia and right frontal lobe. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is bilateral tympanomastoid fluid.
1. Extensive chronic ischemic infarcts and small vessel ischemic disease, but no evidence of acute infarction.2. Bilateral tympanomastoid effusions may represent otomastoiditis.