Seizure, rule out structural cause. Examination is mildly motion degraded. No intracranial mass or mass-effect. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. The bilateral hippocampi are symmetric in size and signal characteristics.Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter as well as in the pons, which are nonspecific, but compatible with chronic small vessel ischemic changes. There is a focus of CSF intensity involving the left lateral thalamus with a rim of gliosis likely representing a lacunar infarct. There is global parenchymal volume loss, commensurate with age. Brain parenchyma is otherwise unremarkable for age.No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. There is a small mucous retention cyst in the left sphenoid sinus. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No intracranial mass or abnormal parenchymal or meningeal enhancement. No findings to definitively suggest a seizure focus.2. Mild chronic small vessel ischemic disease. Chronic lacunar infarct in the left lateral thalamus.3. Global parenchymal volume loss.