Clinical question: Rule out lacunar infarct, posterior circulation stroke. Signs and symptoms: Dysarthria, bilateral upper extremity weakness. Nonenhanced brain MRI:Examination is limited due to extensive motion artifact.No detectable acute intracranial process and in particular no evidence of acute ischemic or lacunar infarct as is questioned clinically.A single suboptimal axial T2 series is also acquired. The sequence demonstrates a few small foci of T2 hyperintensity within the pons without detectable change in size or morphology. Although nonspecific the appearance is suspicious for chronic lacunar infarcts.Small focus of left frontal subcortical T2 hyperintensity without associated mass effect is also suspected of chronic small vessel ischemic stroke.The cortical sulci and ventricular system are slightly prominent for stated age of 50.
1.Limited suboptimal exam due to extensive motion artifact.2.No acute intracranial findings.3.Minimal chronic small vessel ischemic stroke is suspected as detailed above.