Altered mental status There is restricted diffusion on the right middle and inferior frontal gyrus 8 sulcal effacement indicating acute to subacute ischemic infarct. There is no evidence of hemorrhagic transformation.Redemonstration of multifocal chronic ischemic infarct with encephalomalacia involving right frontal lobe, right temporal occipital lobe, left occipital lobe left precuneus. In addition, there are extensive periventricular white matter high signal intensities on FLAIR imaging indicating nonspecific small vessel ischemic disease. Multiple scattered signal void areas on gradient echo which are associated with encephalomalacia indicate hemorrhage transformation foci. These findings do not show any significant interval change since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Retention cyst on the left maxillary sinus
Newly right middle and inferior frontal gyri subacute to acute ischemic infarct as described above without evidence of hemorrhage transformation.No change of multifocal chronic ischemic infarct with encephalomalacia.