Slurred speech [R47.81], Reason for Study: ^Reason: stroke History: slurred speech Multifocal scattered restricted diffusion lesions on the left frontal lobe especially involving precentral gyrus as well as periventricular white matter without evidence of hemorrhagic conversion indicating acute ischemic infarct.There are scattered small focal susceptibility lesions bilateral cerebellar hemispheres, left more than right indicating possible chronic petechial hemorrhages.Patchy bilateral high signal intensities on FLAIR/T2 images at periventricular white matter and centrum semiovale indicate non specific small vessel disease. In addition, there are multifocal chronic lacunar infarction involving right external capsule, left internal capsule anterior limb, and pons.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. 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, Acute ischemic infarctions without evidence hemorrhagic conversion on the right frontal lobe pre central gyrus and periventricular white matter as described above.2. Underlying brain shows non specific small vessel disease with multifocal lacunar infarcts.3. Petechial chronic hemorrhagic lesions on the bilateral cerebellar hemispheres.