 There is a patchy area of diffusion restriction in the right corona radiata measuring approximately 2 x 1 cm. Additionally, there are smaller areas of subcortical white matter diffusion restriction in the right occipital and medial temporal lobes. There is no significant mass effect or midline shift. There is no susceptibility artifact to indicate hemorrhage. There is moderate scattered T2 hyperintensity in the cerebral white matter and the pons suggesting chronic small vessel ischemic disease. The ventricles and sulci are within normal limits. The basal cisterns remain patent. The cerebral flow voids appear to be grossly intact. The lenses are replaced bilaterally.
Recent infarcts of the right corona radiata and subcortical white matter of the right occipital and medial temporal lobes, perhaps in cerebral artery watershed territory distributions, superimposed upon a background chronic white matter small vessel ischemic disease, without midline shift, or hemorrhage. Dedicated head and neck vascular imaging may be useful if clinically warranted.