43 years, Female, left-sided weakness. There are multiple areas of restricted diffusion predominantly in the right cerebral hemisphere including the right frontal, parietal, temporal, and occipital lobes. Diffusion predominantly involves the cortex but also includes the right frontoparietal corona radiata as well as caudate head and putamen on the right. Small foci of restricted diffusion are also noted in the left frontal lobe. There is corresponding FLAIR hyperintensity. Again seen is evidence of multiple chronic lacunar infarcts including the right centrum semiovale, right basal ganglia, and bilateral pons which were present on 11/15/2013. There is no intracranial mass or mass effect. No hydrocephalus. No extra-axial collections. Major flow-voids are preserved. Partially empty sella again incidentally noted. Diffuse low T1 marrow signal is noted which is nonspecific but can be seen in conditions such as chronic anemias.
1. Multiple acute infarcts throughout the right cerebral hemisphere with relatively greater involvement of the right frontal and right parietal cortex. Small acute infarcts involving the right basal ganglia as well as the contralateral left frontal lobe are also noted. 2. No intracranial mass effect. No evidence of hemorrhage on the available sequences (and on recent CT).3. Multiple chronic lacunar infarcts including the right basal ganglia, right centrum semiovale, and bilateral pons which were present on prior study from 11/15/2013.4. Please note patient did not tolerate the study well. Motion degradation is present on some sequences, and SWI as well as postcontrast sequences were not obtained.Dr. Ali discussed findings with Dr. Buerki at 1330 hrs on 7/22/2015.