Patient presenting with dysarthria, slow to follow commands, weakness, evaluate for stroke. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are multiple scattered foci of T2 hyperintensity in the subcortical and deep white matter. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is right sphenoid and bilateral maxillary sinus mucosal thickening and fluid on the left side. There is right tympanomastoid fluid.
1. Findings suggestive of chronic microvascular ischemic disease, but no evidence of acute infarct.2. Findings suggestive of acute sinusitis. 3. Right tympanomastoid fluid may represent otomastoiditis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.