48-year-old female with right-sided weakness, expressive aphasia, left frontal lobe hypodensity identified on prior CT. A recently identified new focus of parenchymal hypo-attenuation in the left frontal lobe premature white matter demonstrates restricted diffusion with matching ADC hypointensity consistent with acute ischemia. There are also other smaller foci of restricted diffusion in the left hemisphere, not identifiable on the prior CT, within the left MCA distribution. There is associated enhancement, however a lack of susceptibility abnormality.A previously identified focus of restricted diffusion within the left mid and superior cerebellar peduncle identified on the 2013 study no longer demonstrates diffusion restriction.A focus of T2 hyperintensity within the right middle cerebellar peduncle is again noted, unchanged. The previous focus of restricted diffusion involving the left middle cerebellar peduncle now demonstrates mild T2 hyperintensity.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no midline shift. The midline structures and cranial-cervical junction are normal. Other than a tiny focus of mucosal thickening within the medial left maxillary sinus, the paranasal sinuses and mastoid air cells are clear. Flow signal abnormality within the posterior circulation is consistent with abnormalities identified on previous CT angiogram performed on 4/9/2015.
1.MRI evidence for subacute ischemia within the left MCA territory.2.Flow signal abnormality within the posterior circulation is consistent with abnormalities identified on previous CT angiogram performed on 4/9/2015. 