Dysphagia. There are areas of encephalomalacia in the left inferior frontal and parietal lobes with associated susceptibility effect. There is a punctate focus of encephalomalacia in the left thalamus as well. There is also a nonspecific punctate focus of susceptibility effect in the right frontal lobe and mild scattered areas of high T2 signal in the bilateral cerebral hemisphere white matter without restricted diffusion. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is a focus of arrested pneumatization of the right sphenoid sinus.
1. Chronic infarcts with associated chronic hemorrhage in the left inferior frontal and parietal lobes, left thalamus chronic lacunar infarct, and a background of probable chronic small vessel ischemic disease.2. No evidence of acute intracranial hemorrhage, mass, or acute infarct.