53 years Male (DOB:7/15/1962)Reason: seizure protocol History: seizure since 2012PROVIDER/ATTENDING NAME: SHASHA WU SHASHA WU The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical white matter lesions present which are high signal on T2 and FLAIR MRI. There are punctate foci of T2 and FLAIR signal hyperintensity in the basal ganglia and thalami as well as the brainstem.There is a focus of encephalomalacia in the inferior aspect of the right cerebellar hemisphere and another one along the right superior frontal gyrus. These are associated with some punctate foci of susceptibility effect. A small focus of encephalomalacia is present in the right occipital lobeThere are multiple foci of signal loss and susceptibility imaging involving the thalami bilaterally as well as some of the subcortical white matter of the temporal lobes and the brainstem.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 demonstrated minor opacities. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a focus of encephalomalacia involving the right superior frontal gyrus which is suspected to be the result of prior ischemic events.2.A focus of encephalomalacia along the inferior aspect of the right cerebellar hemisphere is suspected to be a result of a a prior ischemic event. It is associated with a small lesion in the right medulla suspected to represent an old lacunar infarct.3.A small focus of encephalomalacia is present in the right occipital lobe also likely related to prior ischemic event.4.There are multiple punctate lesions in the basal ganglia and brainstem suspected represent old lacunar infarcts5.Multiple microhemorrhages present, involving the thalami and brainstem as well as a bit of the temporal lobes. These are suspected to have resulted from hypertension based on the pattern.6.Periventricular and subcortical white matter lesions of a moderate degree are nonspecific. At this age they are most likely vascular related. 