 There is near normalization of the previously demonstrated small triangular shaped area of peripheral diffusion hyperintensity is seen in the left corona radiata. There is no new restricted diffusion to suggest the presence of acute ischemia.Redemonstrated is encephalomalacia in the right temporal lobe lobe with ex vacuo dilatation of the right lateral ventricle. As before, there are areas of high T2/FLAIR hyperintensity in the subcortical and the periventricular white matter bilaterally, including the right occipital periventricular white matter somewhat asymmetrically, consistent with chronic ischemic disease.The ventricles and the sulci are prominent suggestive of volume loss, unchanged in extent. Punctate susceptibility is seen in the right temporal lobe, suggestive of chronic blood products in the area of previous infarct. Redemonstrated are bilateral chronic small vessel infarcts.A new small air-fluid level is noted within the right maxillary sinus. Fluid is noted within a few left mastoid air cells, unchanged.
1.There is near normalization of the previously demonstrated small triangular shaped area of peripheral diffusion hyperintensity is seen in the left corona radiata. There is no new restricted diffusion to suggest the presence of acute ischemia.2.Stable chronic small vessel ischemic disease.3.Stable, old, right temporal lobe infarct.