Arm weakness. Rule out stroke.. Brain MRI: There is a punctate lesion in the periventricular white matter of the right occipital lobe is associated with diffusion restriction. There is encephalomalacia in the pons. There are also multiple T2 hyperintense lesions in the cerebral white matter without restricted diffusion. There is no acute intracranial hemorrhage. There is no intracranial mass lesion or midline shift. The ventricles are normal in size and symmetric. The pituitary gland appears unremarkable. The orbits, skull and scalp soft tissues are grossly unremarkable. A T1 hyperintense retention cyst in the maxillary sinus is present. In the left posterior neck, there is a subcutaneous lesion that measures up to 3 cm in diameter and likely represents an inclusion cyst, but is incompletely characterized. Brain MRA: There is no evidence of significant steno-occlusive lesions or aneurysms.
1. Recent punctate infarct in the periventricular white matter of the right occipital lobe. 2. Chronic infarction of the pons and a background of probable chronic small vessel ischemic white matter disease. 3. No evidence of significant steno-occlusive lesions.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.