Right arm and leg weakness, numbness, and pain. Brain MRI: There are several small areas of encephalomalacia in the bilateral basal ganglia and pons. There are also scattered foci of high T2 signal in the cerebral white matter. There are scattered foci of supratentorial and infratentorial susceptibility effect, which may represent chronic microhemorrhages. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the right maxillary sinus. There is a subcentimeter probable Thornwaldt cyst.Brain MRA: There is vertebrobasilar dolichoectasia. Otherwise, there is no evidence of significant steno-occlusive lesions or cerebral aneurysms.Neck MRA: There is no evidence of significant steno-occlusive lesions.
1. Multiple chronic infarcts and small vessel ischemic disease, but no evidence of acute intracranial hemorrhage, mass, or acute infarct.2. No evidence of significant steno-occlusive lesions in the head and neck.