Left side weakness There is no evidence of acute ischemic or hemorrhagic lesion on this scan.Multiple small nodular signal void lesion on bilateral hemispheres on gradient echo images. Diagnostic possibilities include amyloid angiopathy, multiple small hemorrhages, multiple cavernous malformations or calcifications.Multifocal patchy high signal intensities on bilateral periventricular white matter and centrum semiovale on FLAIR images indicate non specific small vessel disease.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, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal distal ICAs, MCAs and ACAs.Acom artery and right Pcom artery are patent but the left Pcom artery is not seen.There is no evidence of intracranial aneurysm.There is no evidence of intracranial arterial luminal stenosis or occlusion.
1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Non specific small vessel ischemic disease as described above.3. Multifocal bi-hemispheric signal voids on gradient echo images indicating possible amyloid angiopathy, multiple small hemorrhages, multiple cavernous malformations or calcifications. 