Altered mental status, unspecified [R41.82], Reason for Study: ^Reason: 61F intubated for respiratory failure, persistently hypertensive post failed extubation attempt History: respiratory failure Multifocal high signal intensity on diffusion-weighted images on bilateral cerebellar hemisphere with the some of lesions show restricted diffusion and remained show subtle high signal intensity on T2 weighted images indicating evolving ischemic stroke lesions likely represent mixed acute and subacute ischemic stroke lesions. The left globus pallidus shows focal high signal intensity lesion on DWI but the lesions shows intermediate signal intensity on T2 images thus indicating evolving subacute ischemic stroke. There is no evidence of hemorrhagic transformation on these lesions.There are multiple susceptibility foci on bilateral hemispheres indicating possible calcifications or chronic petechial hemorrhages. Multifocal scattered FLAIR high signal intensities on bilateral hemispheres and patchy high signal intensity lesions on periventricular white matter indicating non specific small vessel ischemic disease.No evidence of abnormal enhancement.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mucosal thickenings on paranasal sinuses. Bilateral mastoid air cells show opacifications.
1. Mixed acute and subacute evolving ischemic stroke lesions on bilateral cerebellar hemispheres and bilateral basal ganglia as described above without evidence of hemorrhagic transformation.2. Minimal non specific small vessel ischemic disease as described above.