Left lower extremity weakness. There is linear restricted diffusion and T2 hyperintensity in the right thalamocapsular junction/posterior limb of the internal capsule, as well as what appear to be punctate foci of restricted diffusion and T2 hyperintensity in the left posterior periventricular white matter and right parietal lobe subcortical white matter. There are also mild No change from CT ANG HEAD AND NECK WWO with report dated 6/29/2015 7:52 AM.scattered areas of T2 hyperintensity in the cerebral and pontine white matter, including what appears to be a punctate chronic infarct in the right aspect of the corpus callosum. There is no evidence of intracranial hemorrhage or mass. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. A 3 mm right paraophthalmic aneurysm is better depicted on the recent CTA. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is minimal fluid signal in the right mastoid air cells.
1. Acute infarction involving the right thalamocapsular junction/posterior limb of the internal capsule and left posterior periventricular white matter, as well as probable punctate acute infarcts involving the right parietal lobe subcortical white matter without evidence of hemorrhagic transformation, superimposed upon a background of chronic probable small vessel ischemic disease and chronic right corpus callosum infarct.2. A 3 mm right paraophthalmic aneurysm is better depicted on the recent CTA.Discussed with Dr. Javed at 10:30 AM on 6/29/15.