58-year-old male with right facial droop and right upper extremity weakness. Evaluation is slightly limited by patient motion artifact. There is a focus of restricted diffusion in the left putamen/globus pallidus/posterior limb of the internal capsule with associated increased T2 FLAIR signal compatible with acute infarction, but without associated susceptibility artifact suggest hemorrhagic conversion. Patchy and punctate areas of periventricular and subcortical white matter T2 hyperintensity are nonspecific, but suggests chronic small vessel ischemic disease. Patchy areas of susceptibility artifact in the bilateral basal ganglia consistent with chronic hemosiderin staining. There is no midline shift or herniation. There is mild prominence of the CSF spaces suggestive of global parenchymal volume loss. Right maxillary mucosal thickening and mucus retention cyst. The orbits, skull and scalp soft tissues are unremarkable.
1.Acute lacunar infarct of the left basal ganglia/posterior internal capsule, without evidence of hemorrhagic conversion.2.Scattered punctate foci of FLAIR hyperintensity in the periventricular and subcortical white matter are nonspecific, but suggest chronic small vessel ischemic disease.These findings were relayed to Dr. Xiao via telephone at 18:50 on 10/23/2015.