 T2 and FLAIR images demonstrate areas of abnormal signal in the right anterior temporal and right parietal regions relating to areas of gliosis, with associated volume loss in the right parietal region. These 2 areas of high signal correspond to the low attenuation that was seen in the previous CT dated 7/12/2015.Diffusion images demonstrate a focus of high signal in the left superior frontal gyrus, with isointensity in the ADC image. In addition, a focus of restricted diffusion is seen in the deep white matter of the left frontal lobe. The left temporoparietal region demonstrates multiple scattered foci of diffusion restriction. These foci are most likely related to recent infarct of varying age. No diffusion foci are seen in the right cerebral hemisphere.Susceptibility images demonstrates scattered foci of low signal in the left greater than right cerebellum and occipital lobes, most likely representing chronic hemosiderin deposition. There is a focus of more prominent susceptibility in the left central sulcus medially, corresponding to the calcification seen in the previous CT.Chronic lacune is seen in the left cerebellum. Patchy abnormal high signal seen in T2 and FLAIR images in the periventricular white matter including the left putamen which represents chronic ischemic small vessel disease.Ventricular size is normal. The cisterns are patent. No midline shifts. No extra-axial collection of fluid is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is mild mucosal thickening of the bilateral maxillary sinuses
1. Multiple small predominantly left sided supratentorial infarcts of varying ages, ranging from subacute to acute.2. More chronic appearing right parietal and right temporal infarcts. 3. Other scattered chronic ischemic small vessel disease. 4. Scattered foci of hemosiderin deposits in the posterior fossa and occipital lobes.