Transient right-sided weakness. Rule out stroke. BRAIN MRI: There is an area of restricted diffusion along the left posterior frontal corona radiata adjacent to the left lateral ventricle. There is no significant associated FLAIR hyperintensity. There are multiple foci of T2/FLAIR hyperintensity involving the periventricular and subcortical white matter as well as the pons which are nonspecific but compatible with chronic small vessel ischemic disease. The ventricles and other CSF-containing spaces are mildly enlarged, reflecting mild underlying brain volume loss. There is no midline shift or herniation. There is trace mucosal thickening in the ethmoid sinuses. There is deformity involving the posterior aspect of the globes/staphylomas, which may be associated with axial myopia.CRANIAL MRA:The internal carotid arteries show preserved caliber and flow-related signal. There is moderate stenosis involving the distal left M1 segments with mild attenuation of the distal middle cerebral artery branches. Moderate stenoses also involves the proximal left and mid right P2 segments with attenuated distal right posterior cerebral artery branches. Other milder, scattered stenoses involve the intracranial arteries. There is no aneurysm.CERVICAL MRA: Aortic branching pattern is conventional. There is no significant stenosis involving the bilateral common or internal carotid arteries. The vertebral arteries arise conventionally from the respective subclavian arteries. No significant stenosis involving the vertebral arteries at their origins or their course in the neck.
1.Acute/hyperacute ischemia involving the left posterior frontal corona radiata. No significant associated T2/FLAIR signal which may be related to hyperacute timing.2.Mild to moderate chronic small vessel ischemic disease.3.Multifocal atherosclerotic stenoses of the intracranial arteries, with moderate focal stenoses involving the left lateral M1 segment and the bilateral posterior cerebral arteries. 4.There is no significant stenosis of the cervical arteries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.