Dizziness and giddiness [R42], Reason for Study: ^Reason: r/o acute ischemia History: vertigo, nystagmus Linear restricted diffusion lesion on the left frontal lobe deep white matter indicating acute/subacute ischemic infarct. Subtle high signal intensities on DWI on the right thalamus are more likely represent T2 shine through.There is no evidence of acute hemorrhagic lesion on the scan.There are FLAIR/T2 high signal intensity lesions involving bilateral centrum semiovale and periventricular white matter indicating non specific small vessel ischemic disease, unchanged.Multifocal tissue losses involving bilateral basal ganglia, thalamus, right side corpus callosum genu and left external capsule indicating chronic lacunar infarctions, unchanged. 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, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Linear ischemic infarction on the left frontal lobe deep white matter as described above.2. Unchanged non specific small vessel ischemic disease and multiple lacunar infarctions since prior scan.