87 years Female (DOB:10/1/1929)Reason: stroke History: fallPROVIDER/ATTENDING NAME: THOMAS J. KELLY THOMAS J. KELLY MRI of the brainThere is a focus of diffusion restriction present along the posterior aspect of the left paracentral lobule with a larger diffusion weighted abnormality associated with it. Other foci of signal hyperintensity and diffusion-weighted imaging left frontal lobe and right parietal lobe are associated with T2 shine through.There are multiple periventricular and subcortical white matter areas of confluent T2 and FLAIR signal hyperintensity associated with small foci of encephalomalacia in the right inferior parietal lobule, right postcentral gyrus left cuneus, right lingual gyrus , the left inferior frontal gyrus and the right orbital gyrus. The one in the right orbital gyrus, right postcentral gyrus and left inferior parietal lobule present on the prior exam the rest of developed since thenNo abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The right vertebral artery is larger than the left vertebral artery. There is extracranial origin of the left posterior inferior cerebellar artery present.
1.Findings suggest a subacute focus of infarction along the posterior aspect of the left paracentral lobule. 2.Multiple foci of encephalomalacia are scattered in both hemispheres of the brain which are suspicious for prior foci of infarction. Many of these are new since December 20123.There are extensive white matter signal changes throughout much of the brain which are nonspecific. It's possible that these are vascular related. These have significantly progressed since the prior exam from December 20124.No evidence for cerebrovascular occlusive disease.5.No evidence for intracranial aneurysm.