86-year-old male with hyperreflexia and weakness on examination. Please rule out mass or stroke. Two areas of restricted diffusion are visualized within the right MCA territory. A right area of hyperintensity just adjacent to the right lateral ventricle in the right frontal cortex and a small focus just superior to the right frontal horn. There is minimal, if any, associated edema. The ventricles are within normal limits in size and configuration and there is no sulcal effacement. There is no midline shift. There is no intracranial hemorrhage. These areas demonstrate FLAIR/T2 hyperintensity, consistent with subacute rather than hyperacute stroke.There remains asymmetric expansion right greater than left of the postcentral sulci. There is minimal effacement of the right central gyrus. Given differences in technique, this is largely unchanged from prior CT scan. Additionally, there is diffuse volume and prominent ventricles loss likely related to advanced age.Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. Diffusely prominent sulci and ventricles are within normal limits for advanced age.Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Retained mucous cyst within the left maxillary sinus. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of intracranial hemorrhage or mass effect.2. Two areas of diffusion restriction with associated T2/FLAIR abnormality are consistent with subacute stroke. Both of these lesions appear within the right frontal lobe and within the right MCA territory.3. Redemonstration of asymmetric expansion of the CSF spaces overlying the post-central sulci, right greater than left. These findings are unchanged from recent CT scan and likely represent chronic, rather than acute findings.