Reason: STROKE History: STROKE There is a focus of diffusion restriction in the left lateral thalamus compatible with an acute infarct. There is mild associated increased T2 signal without susceptibility to suggest hemorrhage. There are additional scattered areas of increased T2 signal/encephalomalacia without diffusion restriction, particularly in the occipital lobes, right greater than left, bilateral medial thalami, left putamen and bilateral cerebellum, right greater than left which are likely due to chronic ischemia. There is volume loss and gyriform T2 signal associated with the occipital lesions with some increased signal on T1-weighted images, likely reflecting laminar necrosis. Small foci of susceptibility are present within the occipital lesions as well as within the left anterior thalamus, likely reflecting chronic microhemorrhage.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. The orbits, skull and scalp soft tissues are grossly unremarkable. Chronic deformity of the medial wall of the left maxillary sinus.
1.Acute lacunar infarct in the left thalamus.2.Multifocal infratentorial and supratentorial areas of abnormal T2 signal likely represent chronic infarcts, most prominent in the occipital lobes bilaterally.