History of HIV/AIDS. Left-sided weakness and altered mental status. A punctate focus of restricted diffusion with associated FLAIR hyperintensity is visualized along the right paracentral lobule indicating a very small region of acute infarct. There is no mass effect in this area or evidence of edema. There is no evidence of intracranial hemorrhage.A couple of scattered punctate nonspecific foci of signal susceptibility abnormality are noted. There is an unchanged old lacunar stroke in the right thalamus, encephalomalacia in the left peritrigonal region, and diffuse patchy periventricular and subcortical white matter T2/FLAIR signal abnormality which are stable compared to prior exams. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact.Again seen is a deformity of the anterior and lateral walls of the left maxillary sinus which was also present on prior studies and better described on the previous CT.
1.Punctate focus of restricted diffusion in the right paracentral lobule indicating a very small acute infarct. There is no significant edema, abnormal enhancement or mass effect in this region.2.Other underlying white matter changes are stable compared to prior exams.