Right-sided weakness. Evaluate for stroke. The study is severely limited by motion.Parenchymal loss as well as abnormal signal in the left occipital and temporal lobes associated with facilitated diffusion from chronic infarcts. Also moderate confluent periventricular white matter T2/FLAIR signal abnormality (most pronounced in the parietal lobes) is not associated with diffusion restriction and likely reflects chronic microvascular ischemia. There are multiple foci of restricted diffusion involving the bilateral pons and left cerebellum. There is some variation in the degrees of restricted diffusion within the infarcts reflecting differences in timing but appear acute to subacute. Minimal diffusion restriction is also noted involving the left thalamus which demonstrated evolution between CT studies from 7/28 and 8/1/2015.No evidence of significant intracranial mass effect, midline shift, or herniation.
Severely motion degraded study. There is encephalomalacia involving the left temporal and occipital lobes compatible with remote large left PCA infarct. There are multiple foci of varying degrees of diffusion restriction involving the bilateral pons, left cerebellar hemisphere, and left thalamus which are compatible with acute to subacute infarcts. These are grossly similar to prior CT although the differences in technique limit comparison.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.