AMS, right sided weakness and hypertension. There is an area of high T2 signal and restricted diffusion measuring up to 20 mm in the left posterior basal ganglia and corona radiata. There appears to be mild patchy enhancement. There is no evidence of intracranial hemorrhage. There is a background of scattered areas of high T2 signal in the cerebral white matter bilaterally without restricted diffusion and a small focus of encephalomalacia in the right caudate head. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Recent infarct in the left posterior basal ganglia and corona radiata without evidence of hemorrhagic conversion superimposed on chronic small vessel white matter ischemic disease and a chronic right caudate head lacunar infarct.