Reason: ro cva History: dizziness, blurry vision Small foci of diffusion restriction are present in the left pons.On susceptibility imaging punctate foci of hypointensity are present in the cerebellar hemispheres, pons, thalami and basal ganglia and to a lesser degree subcortical and periventricular white matter right hemisphere more than left.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate opacification of the right sphenoid sinus associated with mucosal thickening. Opacification of the right sphenoid sinuses mainly mildly hypointense on T2 and isointense to white matter on T1 The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Findings are compatible with a early subacute lacunar infarct involving the left pons2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.Multiple microhemorrhages are appreciated in a pattern predominantly compatible with hypertension.4.Findings suggest chronic sinus obstruction at the right sphenoid sinus. Etiology is uncertain.