52 years Male (DOB:1/24/1964)Reason: stroke History: acute R facial weakness/anesthesia, dysarthria; chronic imbalance, ?L hemiplegia, L spasticityPROVIDER/ATTENDING NAME: GREGG M HELLAND GREGG M HELLAND MRI of the brainA small focus of diffusion restriction is present along the posterior limb of the left internal capsule which extends into the left globus pallidus. This is associated with T2 and FLAIR signal hyperintensity. It measures approximately 12 x 7 mm axial dimensions.There is a T2 and FLAIR hyperintense punctate focus present in the left cerebral peduncle.There are several periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.The visualized portions of the cervical spine appears to be central disc protrusion at C2-3 which partially effaces spinal fluid ventral to the spinal cord.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.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are small. The vertebral arteries are similar in size.
1.Findings are compatible with subacute lacunar infarct located in the left posterior limb of the internal capsule.2.There are several periventricular and subcortical white matter lesions which are nonspecific. They are most likely vascular related. 3.Findings are compatible with an old lacunar infarct involving the left cerebral peduncle.4.No evidence for cerebrovascular occlusive disease.5.No evidence for intracranial aneurysm.