Reason: concern for acute CVA History: as above; L sided facial droop. MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild scattered cerebral white matter T2 hyperintensity bilaterally. There are also a few punctate foci of susceptibility effect in the bilateral basal ganglia and cerebellar hemispheres. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, mastoid air cells, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the bilateral maxillary and left frontal sinuses. There are bilateral lens implants.MRA: There is no evidence of significant steno-occlusive lesions in the major head and neck arteries. There is no evidence of cerebral aneurysms. There are bilateral retropharyngeal internal carotid arteries.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct. Mild scattered cerebral white matter T2 hyperintensity bilaterally may represent chronic small vessel ischemic disease, while a few punctate foci of susceptibility effect in the bilateral basal ganglia and cerebellar hemispheres may represent chronic microhemorrhages.2. No evidence of significant steno-occlusive lesions in the major head and neck arteries. 