Brief Answer:
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Detailed Answer:
I read your question carefully and your concern reading that report is fully understandable.

The report speaks of several ischemic strokes, or brain infarction. An ischemic stroke happens when a blood vessel in your brain is blocked. Since no organ can survive without blood if the blockage persists after some hours the area which it supplies is infarcted, meaning is irreversibly damaged, its cells are dead.

It can involve big vessels or minor ones. In this case it seems there is involvement of smaller vessels, but there is involvement of many of them, mainly in the posterior part of the brain which is supplied by two blood vessels called the vertebral arteries. The anterior part circulation is not unaffected though there are remains of small vessels infarctions there as well, but old ones, while the posterior ones are more recent. I am a little surprised with the age of 32 you give, this MRI picture is more typical for an elderly person.

Stroke is a very serious issue. While after the first few hours there is no specific treatment for the already damaged areas it is very important that the cause is identified. For that imaging of neck vessels through either ultrasound, CT angiography or MR angiography is necessary as the fact there are several infarctions in the same area makes me think of an issue of the vertebral arteries, such as an atherosclerotic plaque releasing small clots.
The heart must also be evaluated as well as a common source of blood clots, but usually emboli from the heart would affect different territories randomly while in this case the new infarcts are all posterior which makes me think a problem with the vessels more likely.
Factors like high blood pressure, diabetes, high cholesterol, smoking must also be addressed.
At the and some blood thinning product should be administered, but its choice will depend on the cause identified by the above exams.

I remain at your disposal for other questions.

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Brief Answer:
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Detailed Answer:
I did get one page with the brain MRI conclusion.

The brain is the organ which directs the work of all body parts. So naturally its impairment can lead to motor deficits and movement impairment.

The new lesions affect mainly the cerebellum, the small brain. Its main role is in maintaining balance and coordinating movements. So such damage can lead to difficulty walking due to impaired balance and difficulty to coordinate movements. Since there are lesions on both sides they can potentially affect coordination of the limbs on both sides.

There is also a small lesion in occipital area which is the area receiving visual data, so such a lesion can lead to a minor vision impairment.

The old infarctions could have caused some impaired sensation or weakness of the limbs (but they are small so might not have been noticed at all), usually such lesions cause symptoms in the opposite side, since one is on the left and the other on the right again symptoms might have been present on either side.

44 is still a pretty young age to have so many changes. The fact of multiple old and new changes indicates there has been long standing impairment to blood vessels. So as I said before should be taken seriously, find the predisposing factors and address them, in order to avoid more serious consequences in the future.

I hope to have been of help.

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Brief Answer:
Agiographic (blood vessel) study hasn't been done.

Detailed Answer:
Thank you for the full report.

In terms of the brain lesions it doesn't change much, the necessary info was present in the conclusion. On the other hand it confirms what I already suspected, that a satisfactory study of the brain major blood vessels hasn't been done. So I think that apart from the neck study the brain MRI should be repeated including angio MRI, study of the blood vessels.
I know the list of exams might seem daunting, but in such a young patient nothing should be left to chance, I am sure any neurologist would agree.

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