Cerebral infarction, unspecified [I63.9], Reason for Study: ^Reason: assess for new stroke History: right hand weakness, dysarthria, and facial droop Brain MRIThere is restricted diffusion lesion on the left periventricular white matter indicating acute ischemic infarction without evidence of hemorrhagic conversion.Scattered focal tissue lordosis on bilateral basal ganglia and thalami indicating altered focal chronic lacunar infarct.Patch and scattered high signal intensities on periventricular white matter indicating underlying nonspecific small vessel ischemic disease.There are susceptibility lesions on bilateral lateral ventricles' ependymal surfaces which indicate calcifications.There is also focal small susceptibility lesion on the right cerebellar hemisphere indicating chronic petechial hemorrhage.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collectionThe midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate tortuous courses of bilateral ICAs, MCAs, ACAs and vertebrobasilar system without evidence of focal significant (more than 50%) luminal stenosis. No aneurysm was seen.Left vertebral artery is dominant.
1. Acute ischemic infarction on the left periventricular white matter without evidence of hemorrhagic conversion.2. Atherosclerotic intracranial arterial system without evidence of focal luminal stenosis. No intracranial aneurysm.