Clinical question: Slurred speech, RUV/RLE weakness, on therapeutic AC, concerning for possible acute stroke. Signs and symptoms : As above. Nonenhanced brain MRI:Diffusion weighted images demonstrate no evidence of an acute ischemic stroke.Examination demonstrates extensive periventricular and to a lesser degree subcortical foci of flair/T2 hyperintensity in bilateral cerebral hemispheres and suggestive of moderate chronic hemorrhagic small vessel ischemic strokes. Very minimal similar findings are also identified in bilateral basal ganglia and moderate degree and bilateral paramedian pons. Unremarkable cerebral cortex and cortical sulci. Mild dilatation of lateral ventricles likely ex vacuo. The signal void of major intracranial arterial branches are identified.Unremarkable calvarium, soft tissues of the scalp, paranasal sinuses and images through the orbits.
1.No acute intracranial process.2.Findings of mild to moderate chronic non-hemorrhagic small vessel ischemic strokes as detailed.3.Unremarkable nonenhanced brain MRI otherwise.