Evaluate for stroke with history of gait instability. There are small areas of T2 hyperintensity and restricted diffusion within the posterior and inferior left cerebellar hemisphere and posterior medulla. There is no associated hemorrhage. However, there is a small area of susceptibility effect in the right middle cerebellar peduncle. There are a few scattered areas of subcortical and periventricular T2 hyperintensity without restricted diffusion. There is a punctate T1 hyperintense lesion posterior in the pituitary gland, which may represent a Rathke cleft cyst. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is extensive left maxillary sinus mucosal thickening. There appear to be retained secretions within the pneumatized left petrous apex.
1. Small areas of acute infarction within the left cerebellar hemisphere and medulla, mainly in the left PICA distribution, without evidence of acute hemorrhage.2. A few mild subcortical periventricular white matter may represent chronic small vessel ischemic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.