 The exam is degraded by motion artifact.BRAIN: Foci of restricted diffusion are noted in the right dorsal putamen and right parietal periventricular white matter, consistent with acute infarction. Multiple chronic lacunar infarcts are again noted in the bilateral cerebellar hemispheres. FLAIR signal abnormality in the periventricular and subcortical white matter in addition to the pons is consistent with moderate chronic small vessel ischemic disease. Global parenchymal volume loss appears commensurate for the patient's age. There is a small extra-axial mass along the posterior surface of the petrous temporal bone, which has shown gradual growth since 2009 and most likely reflects a meningioma. There is no evidence of intracranial hemorrhage. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a chronic left lamina papyracea fracture. The skull and scalp soft tissues are unremarkable. There is partial opacification of the paranasal sinuses and right mastoid.MRA HEAD: There is no evidence of flow-limiting stenosis or aneurysm within the limitations of motion artifact. The left vertebral artery and A1 segment of the left anterior cerebral artery are diminutive. The left internal carotid artery is slightly smaller than the right. The middle cerebral arteries are unremarkable. The basilar artery is normal in course and caliber. There is a fetal origin of the right posterior cerebral artery.
1. Small foci of restricted diffusion in the right dorsal putamen and right parietal periventricular white matter are consistent with acute infarction. 2. No significant stenosis in the major intracranial vasculature.3. Note examination is moderately motion degraded.