History of heart and kidney transplantation in September 2014. Possible CNS Nocardia infection. There is no evidence of acute ischemic or hemorrhagic lesion on the scan.There is patchy high signal intensity especially on the subcortical white matter on the right inferior frontal gyrus, in particular pars opercularis on FLAIR imaging. The lesion is non enhancing and shows low signal intensity on T1 with subtle evidence of volume loss. Therefore, this lesion is likely represent localized chronic ischemic lesion.Patch periventricular white matter high signal intensity on FLAIR imaging indicates nonspecific small vessel ischemic disease.Scattered small signal void areas especially on bilateral cerebellar hemisphere and left temporal lobe superficial area without evidence of surrounding edema indicate possible parenchymal calcification or chronic hemorrhagic foci.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, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Bilateral maxillary sinus shows mucosal thickening
No evidence of acute ischemic or hemorrhagic lesion.No evidence of abnormal enhancement.Minimal nonspecific small vessel ischemic disease.Possible chronic ischemic lesion on the right inferior frontal gyrus, pars opercularis as described above.