 There are numerous scattered areas of diffusion restriction with high T2 signal and swelling involving both grey and white matter of the left cerebral hemisphere, most prominent in the left occipital and parietal lobes, where there are also punctate foci of susceptibility effect. The right cerebral hemisphere and infratentorial structures are unremarkable. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is scattered mucosal thickening in the paranasal sinuses.
1. Numerous areas of acute infarction in the left cerebral hemisphere, which may be secondary to synthetic marijuana use and less likely secondary to trauma. Head and neck neurovascular imaging may be useful to evaluate for the possibility of underlying dissection. While there may be petechial hemorrhages in the affected left occipital and parietal lobes, there is no evidence of gross intracranial hemorrhage.2. Paranasal sinus disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.