56 years Female (DOB:5/26/1959)Reason: stroke History: left face droopPROVIDER/ATTENDING NAME: SAROSH RANA ADIL JAVED MRI of the brainThere is a focus of diffusion restriction within the left centrum semiovale measuring approximately 16 x 18 mm in axial dimensions. There is another focus of diffusion restriction present in the left half of the splenium of the corpus callosum measuring 17 x 10 mm axial dimensions. There are corresponding FLAIR signal abnormalities.There is a moderate degree of brainstem as well as periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate an opacity in the right sphenoid sinus and mucosal thickening in the right maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. The left posterior communicating artery is not readily identified. There appears to be a 2 mm aneurysm versus infundibulum at the expected location of the origin of the left posterior communicating artery. No right posterior communicating artery is small. The right vertebral artery is smaller than the left vertebral artery.
1.There are lacunar infarcts present in the left centrum semiovale and left splenium of the corpus callosum.2.Findings suggest either aneurysm or infundibulum at the origin of the left posterior communicating artery.3.No evidence for cerebrovascular occlusive disease.4.Periventricular and subcortical white matter lesions and patchy lesions in the brainstem of a moderate degree are nonspecific. At this age they are most likely vascular related. 