91 years Male (DOB:3/17/1925)Reason: stroke History: left facial and arm hypoesthesiaPROVIDER/ATTENDING NAME: CHRISTINE A BABCOCK KOUROSH ANNA REZANIA MRI of the brainNo diffusion weighted abnormalities are appreciated.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a subcentimeter T2 and FLAIR hyperintense lesion present in the right thalamus.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 clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Incidental note is made of C2-3 congenital fusion.Exam is somewhat degraded by motion artifact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. There is fetal origin of the left posterior cerebral artery with a medium sized left P1 segment. The right posterior communicating artery is small. The anterior communicating artery is small. The vertebral arteries are similar in size.The right vertebral artery is smaller than the left vertebral artery.MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. There is mild narrowing at the origin of the right vertebral artery
1.No evidence for acute ischemic cerebral infarction.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.An old lacunar infarct is present in the right thalamus4.There is no evidence for intracranial or extracranial cerebrovascular occlusive disease.5.Examination is somewhat degraded by motion artifact which may obscure more subtle abnormalities.