Medial medullary syndrome.

Clinical presentation left side hemiplegia with weakness of the tongue predominantly on the right lateral aspect with acute Onset giddiness.

A tiny acute embolic infarct in medulla at anteromedial aspect (Medial medullary syndrome).

 Lacunar infarcts in bilateral thalami

 Age related mild volume loss with Fazekas grade I to II periventricular white matter chronic small vessel ischemia.