Left upper extremity weakness. Endstage renal disease. Assess for extent of small vessel disease. There is no restricted diffusion to suggest acute infarct. In addition to mild periventricular T2-hyperintensity, there are multiple scattered T2/FLAIR hyperintense foci in the cerebral white-matter that are most concentrated in the frontal lobes. These are nonspecific but compatible with mild chronic small vessel ischemic disease. There is a focus of susceptibility artifact involving the lateral aspect of the right thalamus, which may represent chronic microhemorrhage versus mineralization. The ventricles and the other CSF-containing spaces are enlarged, reflecting mild-to-moderate underlying global brain volume loss. The major intracranial vascular flow voids are preserved. There is no mass-effect, midline shift or brain herniation.The orbits are grossly unremarkable. There is mild mucosal thickening in the paranasal sinuses. Partially empty sella is incidentally noted which is a normal variant.
1.Mild chronic small vessel ischemic disease.2.Focus of susceptibility effect involving the lateral aspect of the right thalamus, which may represent microhemorrhage versus mineralization.