Weakness. There is restricted diffusion and high T2 signal diffusely within the left caudate nucleus and putamen, as well as smaller gyriform areas of high T2 signal and restricted diffusion in the left anterior temporal lone, left superior frontal lobe, left occipital lobe, left cerebellar hemisphere, and right hippocampus and parietal lobe. There is a background of diffuse cerebral white matter T2 hyperintensity. There is no evidence of intracranial hemorrhage or mass. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There is nonspecific fluid within the bilateral mastoid air cells. There is mild diffuse paranasal sinus mucosal thickening. There are bilateral lens implants.
Acute infarcts in multiple bilateral cerebral hemisphere vascular territories, most extensively involving the left basal ganglia, as well as in the left cerebellar hemisphere, superimposed upon a background of probable chronic small vessel ischemic white matter disease. 