Muscle weakness (generalized) [M62.81], Reason for Study: ^Reason: r/o cerebellar stroke History: RLE weakness, poor balance MRI BRAIN: There is a small area of diffusion restriction in the posterior left frontal lobe periventricular white matter and extending slightly into the posterior aspect of the putamen consistent with acute ischemia. No additional areas of diffusion restriction are identified. There are several foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter, predominantly on the left. Cortical sulci are in proportion to cerebral ventricles. The gray-white matter differentiation is preserved. There is no midline shift or mass effect. No intracranial hemorrhage is identified.MRA BRAIN: The examination is slightly motion degraded. There is irregularity of the right greater than left internal carotid arteries consistent with mild to moderate right and mild left stenosis secondary to atherosclerotic disease as seen on recent prior CT. The bilateral anterior and middle cerebral arteries appear unremarkable. The bilateral vertebral arteries and basilar arteries are grossly unremarkable. There is mild narrowing of the P2 segment of the left posterior cerebral artery. The right P-comm is smaller than the left.
1. Small area of acute ischemia involving the left posterior frontal periventricular white matter.2. Several foci of T2/FLAIR hyperintensity are demonstrated in the periventricular white matter, predominantly on the left. These may represent chronic microvascular ischemic change versus less likely inflammatory or demyelinating etiologies.3. Limited MRA of the brain demonstrates intracranial atherosclerotic disease without evidence for high-grade stenosis or occlusion.