Cerebral infarction, unspecified [I63.9], Reason for Study: ^Reason: Evaluate for L MCA territory ischemia History: dysarthria Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on the scan.Multifocal scattered bihemispheric susceptibility lesions are seen, unchanged since prior scan suggesting chronic petechial hemorrhage or mineralization.Multifocal lacunar infarcts involving bilateral basal ganglia, thalami, and pons are again seen, unchanged.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate complete occlusion of left MCA M1 segment. Otherwise, unchanged right ACA A2 occlusion, significant luminal stenosis of the left ACA P segment and irregularity of bilateral PCA P2 segments.No evidence of intracranial arterial aneurysm.
1. No evidence of acute ischemic or new hemorrhagic lesion on the scan.2. Multifocal susceptibility lesions on bilateral hemisphere, brainstem and cerebellum are again seen, unchanged.3. No evidence of abnormal enhancement.4. Left MCA M1 segment and right ACA A2 segment occlusions as well as multifocal intracranial arterial luminal stenosis indicating intracranial arthrosclerotic changes are again seen, unchanged since prior scan.