Reason: r/o stroke History: as above A punctate single hyperintense are present in the left middle frontal gyrus. Another punctate signal hyperintense lesion diffusion-weighted imaging is present in the left occipital lobe. These are associated with a low signal on ADC maps.A focus of encephalomalacia is present along the left postcentral gyrus . This demonstrated diffusion restriction on the 2013 exam. A smaller focus of encephalomalacia is present in the right occipital lobe and unchanged since prior examThere is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. T2 and flair signal hyperintense lesions are also present in the basal ganglia, thalami and brainstem. These are stable when compared to the previous exam.On susceptibility imaging punctate type of intense lesions are present in the left temporal lobe, left occipital lobe and right temporal low. These were not clearly present on the prior exam. A punctate hypointense lesion in the right middle cerebellar peduncle is also present on the prior exam.Punctate lesions are present in the cerebellar hemispheres which are stable since the prior exam and are bright on T2 and flair. These are likely vascular relatedNormal 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. The left eyeball lens is thin.
1.Findings suggest acute microinfarcts in the left occipital lobe and left frontal lobe.2.Foci of encephalomalacia in the left parietal lobe and right occipital lobe are probably related to prior vascular insults3.There multiple microhemorrhages with several new foci in the left temporal, left occipital and right temporal lobes and an old microhemorrhage in the right middle cerebellar peduncle.4.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are relatively stable when compared to the prior exam.5.Signal changes in the brainstem, basal ganglia and thalami are suspected to be vascular related as well and stable since prior exam6.Punctate lesions are present in the cerebellar hemispheres which are likely vascular related.7.Exam is mildly compromised by patient motion artifact which may obscure more subtle normalities