Other symptoms and signs involving cognitive functions and awareness [R41.89], Reason for Study: ^Reason: eval for stroke, lesion History: facial droop, drooling, unrespsonsive x 10 minutes Brain MRINo evidence of acute ischemic or hemorrhagic lesion. No abnormal enhancement.Scattered multifocal bilateral periventricular white matter T2/FLAIR high signal intensity lesions indicate nonspecific small vessel ischemic disease.Scattered several susceptibility lesions on bilateral hemispheres indicate possible chronic microhemorrhages or mineralizations.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The mastoid air cells are clear.Retention cyst on the right maxillary sinus.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate ectatic changes with tortuosity of the distal intracranial ICAs indicate atherosclerotic changes. However, there is no significant luminal stenosis (more than 50%). There is no evidence of intracranial aneurysm.Distal left vertebral artery is hypoplastic.
1. No evidence of acute ischemic or hemorrhagic lesion. No evidence of abnormal enhancement.2. Nonspecific small vessel ischemic disease.3. Atherosclerotic changes of intracranial arterial system without significant luminal stenosis. 