Altered mental status, unspecified [R41.82] / Cerebral infarction, unspecified [I63.9], Reason for Study: ^Reason: stroke History: aphasia Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on the scan.There are, however, multifocal chronic ischemic lesions with encephalomalacia on bilateral cerebellar hemisphere, left parietal lobe inferior parietal lobule (series 5, image 20/32) bilateral occipital lobes and left temporal lobe posterior aspect of the middle and inferior temporal gyri. In particular, left temporal lobe, bilateral parietal lobes especially inferior parietal lobules and bilateral occipital lobe lesions show susceptibility artifacts especially on the superficial cortex on gradient echo images which indicate possible prior petechial hemorrhage of the ischemic area.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. Bilateral posterior communicating arteries are patent as well as a common artery.
1. No evidence of acute ischemic or hemorrhagic lesion on the scan.2. Multifocal chronic ischemic lesions with encephalomalacia as well as focal hemorrhagic lesions involving bilateral cerebellar and superior, bilateral occipital lobes and the right temporal lobe as described above. 3. Normal brain MR angiogram.