Glasgow coma scale score 3-8, at arrival to emergency department [R40.2432], Reason for Study: ^Reason: stroke?, vascular occlusion? History: AMS Brain MRIMultifocal new restricted diffusion lesions on bilateral frontal lobe indicating acute/subacute ischemic infarct.Due to the nature of emergency circumstances and per the request of the ordering service, no other MR sequence has been obtained but diffusion weighted sequence.Therefore, other information such as hemorrhagic transformation, evolution of prior ischemic stroke lesions and brain edema can not be evaluated. Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate significant (more than 50%) luminal narrowing of the left MCA distal M2 segment. Unchanged since prior scan.There are also multifocal various degree luminal stenosis of bilateral MCA M2 and M3 segment branches indicating intracranial atherosclerotic changes. Vertebrobasilar system appears to be normal.
1. Acute/subacute ischemic infarctions on bilateral frontal lobes.2. Significant (more than 50%) luminal stenosis of the left MCA M1 segment, unchanged since prior scan.