Male, 76 years old, with memory problems, altered mental status, word finding difficulties, prolonged hypotension secondary to shock. Encephalomalacia is seen in the paramedian right frontal lobe with surrounding parenchymal T2 hyperintensity suggesting gliosis. Additional scattered foci of T2 hyperintensity are seen in the periventricular regions. No restricted diffusion is observed.No parenchymal edema or mass effect is noted. There are no findings to suggest acute intracranial hemorrhage or any abnormal extra-axial fluid collection. The ventricular system is normal in size and morphology.Mucosal thickening and secretions are seen in the right maxillary sinus and the sphenoid sinuses.
1.No evidence of acute ischemia or any other definite acute intracranial abnormality.2.Encephalomalacia and gliosis in the right paramedian frontal lobe likely represents chronic ACA territory infarction.3.Moderate chronic microvascular ischemic disease is also seen.4.Sinus mucosal inflammation as above.