Dense aphasia, right arm/leg ataxia. There are multiple areas of cortical encephalomalacia in the bilateral cerebral hemispheres and patchy areas of white matter T2 hyperintensity. There is also encephalomalacia in the bilateral cerebellar hemispheres, right more than left. There are a few unchanged scattered punctate foci of susceptibility effect in the bilateral posterior cerebral hemispheres. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the bilateral maxillary sinuses.
Multiple chronic infarcts in multiple cerebral territories and in the bilateral cerebellar hemispheres, but no evidence of acute infarct.