Female, 67 years old, with aphasia and right-sided weakness. Mild diffusion hyperintense signal is seen within the left precentral gyrus and in the subjacent corona radiata. There is only mild corresponding ADC hypointensity. This area shows corresponding T2 hyperintensity and there is mild edema in the form of a slight deformation of the left lateral ventricular margin.No other definite acute ischemic lesions are seen. Fairly extensive patchy periventricular T2 hyperintensity is noted bilaterally but without mass effect. The pons is also involved to a lesser degree.No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid collections is seen. The lateral ventricles are disproportionately prominent relative to the caliber of the sulci as noted on prior CTs. The fourth ventricle is within normal limits.
1.Findings compatible with an ischemic lesion of likely subacute timecourse involving the left precentral gyrus and subjacent corona radiata. Discussed with Dr. Dimaggio at 10:45AM on 12/11/15.2.Evidence of extensive prior small vessel and lacunar ischemic disease.3.Prominence of the lateral ventricles out of proportion to the caliber of the sulci is seen. This can reflect preferential central volume loss but similar findings can also be seen in normal pressure hydrocephalus.