Clinical question: Right capsular stroke. Signs and symptoms: Left hemiparesis. Nonenhanced brain MRI:A small acute right basal ganglia lacunar infarct measuring at least at 6 x 13 mm in transaxial dimensions is again identified. This finding demonstrates a punctate focus of susceptibility (series 401 image 130) suspected of hemorrhage.Additionally exam demonstrate moderate chronic nonhemorrhagic small vessel ischemic strokes in the periventricular and subcortical white matter as well as bilateral basal ganglia and left thalamus.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise.The signal void of all major intracranial arterial branches are identified and unremarkable.Images through the orbits demonstrate a chronic right lamina papyracea blowout fracture similar to prior CT examination and unremarkable orbits otherwise.Mild chronic right maxillary sinus disease and unremarkable other paranasal sinuses and mastoid air cells.
1.Acute right basal ganglia lacunar infarct (at least at 6 x 13 mm) with a punctate focus of susceptibility.2.Chronic nonhemorrhagic small vessel ischemic strokes of subcortical, periventricular white matter as well as bilateral basal ganglia.3.Chronic right lamina papyracea blowout fracture.4.Mild chronic right maxillary sinus disease and unremarkable sinuses otherwise.