67 years Male (DOB:12/21/1948)Reason: assess limited MRI of head History: AMSPROVIDER/ATTENDING NAME: SHANNON K MARTIN HEMAL M. NAYAK MRI of the brainThere is redemonstration of diffusion restriction involving the right centrum semiovale and right periventricular white matter at the trigone and right occipital lobe. There is no evidence for hemorrhagic conversion. The extent has not changed since the prior exam, however, the signal intensity on DWI has decreased.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. There is fetal origin of the PCA bilaterally associated with a hypoplastic p1 segment on the right and a small to medium sized p1 segment on the left. The right SCA is predominantly supplied via the anterior circulation. The RVA is hypoplastic intracranially
1.There is redemonstration and continued evolution of foci of subacute infarction involving the right centrum semiovale and right periventricular white matter at the trigone and right occipital lobe. These have not changed in extent compared to the prior exam. There is no evidence for hemorrhagic conversion at this time.2.There is bilateral fetal origin. The right SCA is predominantly supplied via the anterior circulation. The RVA is hypoplastic