Clinical question: Rule out infarct. Signs and symptoms: Generalized weakness, and veering to right. Nonenhanced brain MRI:No evidence of acute ischemic stroke on diffusion weighted series.Examination demonstrates diffuse periventricular and to a lesser degree subcortical foci of flair hyperintensity with mild ex vacuo dilatation of lateral ventricles. Minute similar findings are noted in the pons. Findings are nonspecific however likely representing mild degree of chronic nonhemorrhagic small vessel ischemic strokes considering patient's stated age of 77.There is no detectable cortical signal abnormality. There is normal signal intensity of bilateral basal ganglia and thalami as well as vermis and cerebellar hemispheres.
1.No evidence of acute ischemic stroke.2.Findings suggestive of mild nonhemorrhagic small vessel ischemic strokes in the periventricular and to a lesser degree subcortical white matter and minimally in the pons as detailed.3.Unremarkable nonenhanced brain MRI otherwise.