Patient History
53-year-old man with "transient ischemic attack "
MRI brain without contrast:
Findings
Triangular focus of restricted diffusion in the superior right periatrial region for instance with a smaller more subtle focus in the left parietal subcortical region. Moderate to marked scattered periventricular and subcortical T2 FLAIR hyperintensities. Focus of cystic encephalomalacia in the right thalamus. The major intracranial flow voids are patent. Visualized paranasal sinuses and mastoid air cells are clear. No pathologic increased susceptibility.
Impressions
Irregular focus of restricted diffusion in the right periatrial region and small rounded focus of restricted diffusion in the left parietal subcortical region. Moderate nonspecific subcortical and periventricular T-2 FLAIR hyperintensities with focus of cystic leukomalacia in the right thalamus. Overall, findings could reflect recent ischemia superimposed on chronic small vessel ischemic disease in the appropriate clinical context. Vasculopathy or inflammatory/demyelinating disease could also be considered appropriate clinical context.
