Right arm numbness. There is a subcentimeter focus of restricted diffusion and high T2 signal in the left thalamus. There is T2 hyperintensity in the right paramedian pons without associated restricted diffusion. There is also scattered cerebral white matter T2 hyperintensity. There is no evidence of intracranial hemorrhage or mass. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Punctate acute infarct in the left thalamus.2. Chronic right pontine lacunar infarct.3. Probable chronic small vessel white matter disease.Discussed with Dr. Rubeiz at 10:30 AM on 3/10/15.