Left hemispheric syndrome. There is a subcentimeter area of restricted diffusion involving the left postcentral gyrus with associated high T2 signal. There is a punctate defect in the left thalamus. There is moderate predominantly periventricular cerebral white matter T2 hyperintensity. There are a few scattered punctate foci of susceptibility effect in the cerebral hemispheres. There is no evidence of intracranial mass. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the left maxillary sinus.
Punctate acute infarct involving the left postcentral gyrus superimposed upon moderate probable chronic small vessel ischemic disease, a chronic lacunar infarct in the left thalamus, and chronic microhemorrhages.Discussed with Dr. Guan at 10:10 AM on 5/15/15.