63 years, Female, right face and arm sensory alterations. Reports a brain hemorrhage in April 20, 2014, unknown etiology. Any sign of vascular malformation.. Compared to prior there is interval development of focus of susceptibility effect in the left thalamus with mild volume loss and consistent with chronic hemorrhage. No adjacent mass, abnormal enhancement, or abnormal flow voids. No additional foci of susceptibility effect are appreciated elsewhere in the brain. There is moderate burden of T2/FLAIR hyperintense lesions involving the bilateral periventricular and subcortical white matter which are nonspecific but compatible with chronic small vessel ischemic disease. Brain parenchyma is otherwise unremarkable for age. No restricted diffusion to suggest acute ischemia. No findings to suggest acute intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Evidence of chronic hemorrhage involving the left thalamus. No underlying mass, abnormal flow-voids, or abnormal enhancement is appreciated. Finding has developed in the interval when compared to 4/26/2013.2. Moderate chronic small vessel ischemic changes.