History of stroke now with new onset generalized tonic-clonic seizure. Evaluate for new stroke. There is no evidence of acute intracranial hemorrhage, mass effect, or acute infarct. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with extensive chronic small vessel ischemic changes. Lacunar infarcts are noted involving the bilateral corona radiata, external capsules, along the caudate heads, left pons, and right cerebral hemisphere. Chronic blood products are noted associated with the small right cerebellar infarct. Encephalomalacia is seen involving the right inferior frontal and right anterior and inferior temporal lobes. No abnormal parenchymal or meningeal enhancement.The ventricles and sulci are prominent, consistent with moderate age-related volume loss. The basal cisterns remain patent. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable.
1.No evidence of acute infarct. No intracranial mass or mass effect.2.Multiple chronic lacunar infarcts as well as right frontotemporal cortical encephalomalacia as described above. Extensive chronic small vessel ischemic changes. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.