46 years, Male, left-sided weakness. Evaluate for acute stroke. There is motion degradation on multiple sequences. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Mild gliosis and subtle volume loss in the right anterior temporal lobe is unchanged. There is also global parenchymal volume loss, which appears advanced for age. No hydrocephalus. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of acute infarct.2. Mild chronic small vessel ischemic changes.3. Mild global parenchymal volume loss, which is advanced for age, similar to prior. 4. Mild right anterior temporal encephalomalacia is also unchanged, which may be related to remote trauma or other injury.