59-year-old male with dysarthria and imbalance. Evaluate for stroke. No evidence of intracranial hemorrhage, mass, or acute infarct. There is encephalomalacia seen in the right frontal lobe. There are postsurgical changes within the right parietal region with abnormal FLAIR signal and evidence of old blood products involving the right parietal lobe. The diffusion hyperintensity in this region is likely artifactual related to the blood products. There is no evidence of mass. There is abnormal focus of FLAIR signal in the left occipital lobe which may also be related to prior infarct. There is additional mild-to-moderate scattered periventricular and subcortical white matter hypoattenuation which is nonspecific and likely related to chronic small vessel ischemic disease.There is mild prominence of the extra-axial CSF spaces along the bilateral cerebral convexities which is favored to be related to the patient's global parenchymal volume loss although small subdural effusions without mass effect remain a small possibility. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact.
1.No evidence of intracranial hemorrhage, mass, or acute infarct. 2.Post-surgical changes of a prior right parietal craniotomy with focus of right parietal lobe encephalomalacia with chronic blood products. 3.Right frontal lobe encephalomalacia and evidence of an additional probable small infarct involving the left occipital lobe.4.Scattered mild-moderate chronic likely small vessel ischemic disease.