 MRI Brain:There are multifocal punctate foci of restricted diffusion seen in the supratentorial subcortical and deep white matter bilaterally, medial anterior left thalamus, and infratentorially involving the right lateral cerebellar hemisphere. There is associated FLAIR signal abnormality but no abnormal parenchymal enhancement, focal mass effect, midline shift, herniation or evidence of hemorrhagic conversion.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA Brain: The intracranial internal carotid arteries demonstrate no significant stenosis. The middle and anterior cerebral arteries are also patent. The vertebral arteries, basilar artery, and posterior cerebral arteries also are patent with no significant stenosis. No evidence of aneurysms or vascular malformations.MRA Neck: Severely limited exam secondary to motion. The origins of the major arteries arising from the aortic arch are not visualized secondary to technique. In addition, the proximal to mid right carotid vessels are not well visualized and cannot be reliably assessed. The left-sided carotid vessels and the vertebral vessels show no gross abnormality.
1.Multifocal punctate nonhemorrhagic infarcts involving the supratentorial subcortical and deep white matter bilaterally, medial anterior left thalamus, and infratentorially involving the right lateral cerebellar hemisphere. There is no focal mass effect, midline shift, herniation or evidence of hemorrhagic conversion.2.No significant intracranial vascular abnormality.3.Limited MRA of the neck. In particular the right carotid system is not reliably assessed. No gross abnormality of the left carotid system or the vertebral arteries is seen.