Female, 65 years old, with left-sided weakness, gait difficulty, and neuropathy. Status post heart transplant on immunosuppression. No restricted diffusion is seen. Scattered small foci of T2 hyperintensity are seen within the subcortical and periventricular white matter which likely reflect chronic microvascular ischemic disease. Multiple small chronic cortical infarcts are seen within the cerebellum.No evidence of parenchymal edema or mass effect is seen. No abnormal extra-axial fluid collections are detected. No pathologic parenchymal or extra-axial enhancement is observed. The ventricles are normal in size and morphology.Intracranial MRA imaging reveals no evidence of any significant vascular stenosis or vascular occlusion. No aneurysms are detected within the limitations of technique.Postcontrast MRA imaging of the neck is compromised by poor contrast bolus timing. However, a noncontrast time-of-flight MRA sequence was obtained through the neck and this is of adequate quality. No significant vascular stenosis is detected within the carotid or vertebral vessels of the neck.
1.No acute ischemia or other acute intracranial abnormality.2.Evidence of scattered chronic small vessel and cerebellar cortical ischemic lesions.3.No findings to suggest any intracranial infectious or neoplastic process.4.No significant vascular abnormalities in the head or neck.