60 female patient with history right arm numbness two days ago with persistent numbness in right hand. Possible infarct on head CT. There is a focus of restricted diffusion within the left thalamus compatible with acute ischemia. There is no associated susceptibility artifact to suggest hemorrhage. There is otherwise patchy subcortical and periventricular abnormal T2/FLAIR signal abnormality corresponding to chronic small vessel ischemic disease. A focus of encephalomalacia within the right thalamus is compatible with a chronic lacunar infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mucosal thickening within the floor of the right maxillary sinus. The orbits, skull, and scalp soft tissues are grossly unremarkable.
1. Left thalamic acute ischemic infarct.2. Chronic small vessel ischemic disease and chronic right thalamic lacunar infarct.Findings were discussed by the RROC with Dr Lu by telephone at 1800 hrs on 9/11/2016. 