Female, 63 years old, with breakthrough seizures and bilateral spasticity due to prior intracranial hemorrhage, ischemic stroke and microhemorrhages. An 8 mm mildly diffusion restricting lesion is seen within the left corona radiata. A larger region of mild restricted diffusion, spanning approximately 2 cm, is seen in the anterior medial right occipital lobe.Extensive patchy and focal areas of T2 hyperintensity are seen within the cerebral hemispheres and the cerebellum with a distribution which is overall similar to the prior examination. Very mild local edema is seen in the anterior medial right occipital lobe. Otherwise, no significant mass effect is detected.No evidence of acute intracranial hemorrhage is seen. Numerous scattered punctate foci of susceptibility are seen throughout the brain compatible with chronic microhemorrhage appearing similar to prior. A more extensive region of hemosiderin staining along the right thalamic contour may relate to a prior hemorrhagic lesion. Ventricular size and contour are unchanged.
1.An area of late acute or subacute right PCA distribution ischemia is seen involving the anterior medial occipital lobe.2.A late acute or subacute small vessel ischemic stroke is evident in the left corona radiata.3.Evidence of extensive prior ischemia with scattered microhemorrhage is grossly unchanged.