Do not resuscitate [Z66], Reason for Study: ^Reason: eval for microvascular disease, explain etiology of AMS History: AMS Significant motion artifact degraded exam quality.There are couple of high signal intensities on DWI including left side corpus callosum mid-body and posterior body. However, there is no definitive evidence of restricted diffusion on ADC map. Thus, these lesions could be late subacute ischemic lesions or could be T2 shine through from focal encephalomalacia.There are multiple T2/FLAIR high signal intensity lesions on the right frontal,parietal and posterior temporal lobes but further characterization is challenging due to significant patient's motion. These lesions represent chronic ischemic infarction related encephalomalacia most likely comparing to prior CT scan.The ventricles, sulci and cisterns are unremarkable. The paranasal sinuses are clear.Bilateral mastoid air cells show fluid collections.
1. No definitive evidence of acute ischemic or hemorrhagic lesion though a couple of DWI high signal intensity lesions as described above.2. Multifocal most likely on the right hemispheric chronic ischemic infarction with encephalomalacia.