Paresthesia. There is a subcentimeter area of restricted diffusion and high T2 signal in the left thalamus with punctate foci of susceptibility effect. There are a few other foci of supratentorial and infratentorial susceptibility effect that scattered about, predominantly involving the deep grey matter. There is extensive cerebral white matter T2 hyperintensity without associated restricted diffusion. There are also more focal defects in the right corona radiata, right caudate, and right thalamus. There is a cavum septum pellucidum. The ventricles are otherwise unremarkable. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.
Acute infarct in the left thalamus, superimposed upon probable hypertensive chronic microhemorrhages, chronic lacunar infarcts and extensive small vessel ischemic white matter disease.Discussed with Dr. Javed at 1:30 PM on 1/21/15.