 The study is degraded by extensive motion artifact.MRI BRAIN:A small triangular shaped area of peripheral diffusion hyperintensity is seen in the left corona radiata, which is iso- to hyperintense on ADC, suggestive of subacute infarct.There is encephalomalacia in the right temporal lobe lobe with ex vacuo dilatation of the right lateral ventricle. There are areas of high T2/FLAIR hyperintensity in the subcortical and the periventricular white matter bilaterally, including the right occipital periventricular white matter somewhat asymmetrically, consistent with chronic ischemic disease.The ventricles and the sulci are prominent suggestive of volume loss. Punctate susceptibility is seen in the right temporal lobe, suggestive of chronic blood products in the area of previous infarct. There is a chronic lacunar infarct involving the right corona radiata.MRI BRAIN:There is slight dorsal convexity of the right internal carotid artery terminus but appears to represent a minimally tortuous A1 origin, with no definite aneurysm. The left A1 segment is hypoplastic, and therefore the left ICA is smaller than the right. Otherwise, there is no flow limiting stenosis or aneurysm in the cerebral arteries.NECK MRA: There are mild irregularities of the carotid vessels. There is eccentric convexity of the medial margin of the mid left common carotid artery, likely related to atherosclerotic ulcerated plaque. There is mild narrowing of the left carotid bulb.There is eccentric narrowing of the left subclavian artery just distal to the left thyrocervical trunk, likely related to atherosclerotic plaque.There is anterolisthesis of C3 on C4.
1. A small focus of probable subacute infarct in the left corona radiata.2. Right temporal lobe chronic infarct, with chronic ischemic changes in the right occipital white matter and elsewhere in the periventricular white matter.3. Significantly motion-limited exam. No definite aneurysm or hemodynamically significant stenosis in the cerebral and the cervical arteries. There are irregularities of the cervical carotids with mild narrowing of the left carotid bulb.