Left-sided facial weakness. Assess for stroke. The examination is moderately limited by patient motion.Brain MRI: There is no acute brain infarct or acute intracranial hemorrhage. Redemonstrated is small focus of encephalomalacia involving the left precentral gyrus, reflective of previous infarct. There are punctate foci of T2 FLAIR hyperintensity in the cerebellar hemispheres, right more than left, and the right hippocampus which probably also represent small chronic ischemia. Small CSF intensity focus in the right basal ganglia may represent dilated perivascular space or chronic infarct. There is relatively mild periventricular an subinsular T2 FLAIR hyperintensity, reflective of chronic microvascular ischemia. The ventricles and the other CSF-containing spaces are mildly enlarged, reflective of mild global parenchymal volume loss. There is no mass-effect or midline shift. The major intracranial vascular flow voids are preserved, reflecting gross patency. There is no gross orbital abnormality. Mastoid air cells are clear. There is a small retention cyst in the right maxillary sinus and trace mucosal thickening in the paranasal sinuses. The adenoids are prominent which is nonspecific most likely reactive.Cranial MRA:Flow-related signal in the major intracranial arteries is preserved as well as the vessel caliber without significant stenosis. Of note, the upper most cervical segment of the left internal carotid artery is tortuous.
1.Examination is moderately limited by patient motion.2.There is no acute infarct. Left precentral, right hippocampal and bilateral cerebellar small, chronic infarcts are present.3.No flow-limiting intracranial arterial stenosis.