Visual disturbance. Word-finding difficulties. There is a punctate focus of restricted diffusion in the posterior left putamen. There is a background of mild cerebral white matter T2 hyperintensity, which is nonspecific, but may represent chronic small vessel disease. There is no evidence of intracranial hemorrhage or mass. The brain parenchyma otherwise appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There are scattered subcentimeter paranasal sinus retention cysts.MRA
1. A punctate focus of restricted diffusion in the posterior left putamen is compatible with an acute lacunar infarct. 2. No evidence of significant steno-occlusive arterial lesions.3. Fusiform dilatation of the left V4 vertebral artery with a superimposed 5 wide mm wide based aneurysm. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.