 There is redemonstration of a small area of diffusion restriction along the lateral aspect of the posterior right dorsal medulla with associated T2 hyperintensity. There is no evidence of intracranial hemorrhage. The ventricles and sulci are unchanged in size and configuration. The basal cisterns remain patent. There is no midline shift or mass effect. The distal right vertebral artery flow-void appears to be markedly narrowed. There is mild mucosal thickening in the right maxillary sinus with suggestion of chronic inflammatory changes.
Right dorsolateral medulla recent infarct without evidence of hemorrhagic transformation. Associated with steno-occlusive disease of the distal right vertebral artery, which is better depicted on the recent CTA. 