 BRAIN: There is no evidence of restricted diffusion to suggest acute ischemic infarction. There is a small focus of chronic encephalomalacia within the right cerebellar hemisphere appearing similar to 2013 CT. Punctate and confluent foci of increased T2/FLAIR signal within the supratentorial white matter are nonspecific but favored to represent mild-moderate chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration for age. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. Postcontrast images do not demonstrate any abnormal parenchymal enhancement.MRA HEAD: The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. The right P-comm is not definitively visualized. The left P-comm is diminutive. There is no evidence of flow-limiting stenosis or aneurysm.
1.No acute ischemic infarction.2.Chronic mild-moderate small vessel ischemic changes.3.Small chronic infarction in the right cerebellar hemisphere.4.MRA without evidence of flow-limiting stenosis or aneurysm.