Female, 72 years old, with weakness and gait problems. Brain:Since the prior examination, foci of restricted diffusion within the left thalamus and right pons have resolved. However, there is a new 6 mm focus of restricted diffusion along the right postcentral sulcus.Extensive patchy periventricular and subcortical T2 hyperintensity is seen, appearing similar to prior. Also noted are numerous scattered lacunar infarcts involving the basal ganglia, midbrain and pons. Numerous small cortical strokes are also seen in the cerebellum. Overall, these findings have not substantially changed from prior.Numerous scattered small foci of stability are seen relating to the areas of prior ischemic injury. No evidence of acute intracranial hemorrhage is seen. No abnormal extra axial fluid collections are detected. The ventricles remain normal in size and morphology.C-spine:Please note that most sequences are degraded by motion artifact, and in particular, the axial sequences are of poor quality and offer little diagnostic information. T2 axial images were not acquired as the patient requested to terminate the exam.The cervical lordosis is straightened but alignment is otherwise unremarkable. Vertebral body morphology is normal. No concerning marrow replacement or marrow edema is seen.The spinal cord shows normal signal intensity and morphology, as assessed on sagittal images only.C2-3: Unremarkable. C3-4: Unremarkable. C4-5: Right foraminal/subarticular disk osteophyte complex. Mild right neuroforaminal narrowing. Otherwise unremarkable.C5-6: Unremarkable. C6-7: Unremarkable. C7-T1: Unremarkable.
1. A new small focus of acute ischemia is seen along the right postcentral sulcus.2. Evidence of extensive chronic microvascular and lacunar ischemia in the brain.3. Limited evaluation of the cervical spine but without obvious findings to account for the patient's symptoms.