Cerebral infarction, unspecified [I63.9], Reason for Study: ^Reason: assess for new stroke History: left face, arm, \T\ leg weakness \T\ numbness, slurred speech, gait imbalance Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on this scan.There is, however, pontine atrophic changes with demonstration of so called hot cross bun sign on FLAIR/T2 images. There are also bilateral middle cerebellar peduncular atrophies (left greater than right) and encephalomalacia on the left cerebellar hemisphere which is corresponding to prior ischemic infarction.Above findings do not show any interval change since prior scan.The prepontine cistern is prominent due to pontine volume loss. Otherwise the ventricular systems is unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.No aneurysm. No significant intracranial arterial luminal stenosis.
1. No evidence of acute ischemic or hemorrhagic lesion.2. No evidence of intracranial major vessel occlusion. No aneurysm.3. Atrophic changes of pons, bilateral cerebellar peduncles (left worse than right) and left cerebellar encephalomalacia with MR evidence of so called hot cross bun sign. Unchanged since prior scan. 