 MRI Brain:A moderately sized area of somewhat patchy restricted diffusion is seen within the right occipital lobe correlating with the CT abnormality. Minimal susceptibility effect is seen in this area which could indicate petechial blood product. No frank hematoma is seen. One or two small foci of restricted diffusion are also suspected within the left occipital lobe. Mild local edema seen, but there is no significant generalized mass effect effect, midline shift or herniation. Minimal periventricular T2 hyperintensity is seen. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA Brain: The intracranial left vertebral artery is small and poorly visualized whereas on the prior MRA it was well-demonstrated. A possible mild narrowing of the mid basilar artery is seen, but this is unchanged. A moderate focal stenosis of the left distal P2 PCA is unchanged. Otherwise, no obvious anterior or posterior circulation deficits are seen. Redemonstrated is a 3 x 4 mm right MCA bifurcation aneurysm without significant change from the previous exam. A 2 mm aneurysm arising from the left A2 segment of the ACA is unchanged as well. MRA Neck: Descending aortic dissection is partially visualized on this examination. There is common origin of the brachiocephalic and left common carotid arteries. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. There is a smaller left and dominant right vertebral artery. There is no evidence of stenosis or occlusion.
1.Findings compatible with acute infarction involving the right greater than left posterior occipital regions.2.Moderate focal stenosis of the left P2 PCA, unchanged. Possible mild narrowing of the mid basilar artery, unchanged.3.Poor visualization of the intracranial left vertebral artery is new from the prior MRA and could represent a technical artifact or superimposed atherosclerotic disease.4.Aneurysms at the right MCA bifurcation and along the left A3 ACA are unchanged. No definite evidence of any new aneurysm is seen.5.A descending aortic dissection is partially visualized.