Fluctuating Wiernicki and persistent right face and arm weakness. There is an area of high T2 signal and restricted diffuse in the medial left thalamus that measures up to 20 mm. There may be punctate foci of susceptibility effect within this lesion. There is a small chronic infarction in the left cerebellar hemisphere. The rest of the brain parenchyma appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Small left medial thalamus acute infarct with possible petechial hemorrhages, although assessment is limited by patient motion artifact. Small chronic infarction in the left cerebellar hemisphere.