62 years Female (DOB:2/21/1954)Reason: acute infarct History: slurred speech, AMS, h/o CVA, old lacunar infarct R caudatePROVIDER/ATTENDING NAME: JEANNE M. DECARA MRI of the brainNo diffusion weighted abnormalities are appreciated.There is encephalomalacia involving the right centrum semiovale and basal ganglia associated with some cystic components. There is slitlike appearance to the atrophy. There is associated susceptibility effect. There is ex vacuo effect along the right lateral ventricleThere is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Susceptibility weighted imaging is degraded by patient motion.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries. The right middle cerebral artery appears narrowed as along the mid M1 segment with approximately 70% stenosis measuring 1 cm in length.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The left P1 segment and left posterior communicating artery are similar in diameter. The right posterior communicating artery is very small The vertebral arteries are similar in size.
1.There is 70% stenosis present along the midportion of the right M1 segment along the 1 cm length segment of the vessel.2.No evidence for intracranial aneurysm.3.Encephalomalacia along the right basal ganglia and adjacent centrum semiovale is likely related to prior hemorrhage.4.Periventricular and subcortical white matter lesions of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. 5.Susceptibility weighted imaging is degraded by patient motion. This may lower the sensitivity for hemorrhagic lesions on this exam.6.Alphanumeric page was sent to Obada Shamaa pager 7582 at the time of this interpretation and the findings were reported to him.