57 years Male (DOB:3/21/1959)Reason: stroke History: Left hemiparesis and hemiataxiaPROVIDER/ATTENDING NAME: JAMES R. BRORSON JAMES R. BRORSON MRI of the brainThere is encephalomalacia present along the medial aspect of the left cerebellar hemisphere. No foci of diffusion restriction are currently appreciated intracranially.There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.On susceptibility imaging there are 2 or 3 subcortical and periventricular punctate foci of signal hypointensity. In isolation these don't clearly establish a pattern given their small number..The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal right vertebral artery, the basilar artery and the proximal anterior, middle and posterior cerebral arteries. The left vertebral artery is occluded. There appears be some reverse filling of the distal left vertebral artery.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. There is fetal origin of the posterior cerebral arteries bilaterally. The P1 segments are small. The anterior communicating artery is very small.
1.Chronic stage infarction involving the left cerebellar hemisphere. 2.No evidence for cerebrovascular occlusive disease.3.No evidence for intracranial aneurysm.4.Periventricular and subcortical white matter lesions of a mild to moderate degree are nonspecific. They are most likely vascular related. 