Dysarthria and anarthria [R47.1], Reason for Study: ^Reason: please rule out acute infarct History: new dysarthria in known vasculopath There is focal restricted diffusion area on the left frontal lobe precentral gyrus without evidence of hemorrhagic conversion indicating acute ischemic infarction.Underlying brain shows multiple scattered T2/FLAIR high signal intensities on bilateral centrum semiovale and periventricular white matter indicating non specific small vessel ischemic disease.There is susceptibility lesion on the right periventricular white matter indicating prior hemorrhagic lesion. Scattered susceptibility lesions on bilateral insular and right thalamus suggest petechial hemorrhages or calcifications.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Acute ischemic infarction without hemorrhagic conversion on the left frontal lobe precentral gyrus.2. Underlying brain shows non specific small vessel ischemic disease.3. Chronic hemorrhagic lesion on the right periventricular white matter.