Stroke workup: right sided weakness. Brain MRI: There is an area of high T2 signal and restricted diffusion as well as faint patchy enhancement in the posterior left basal ganglia and corona radiata. There also a a punctate focus of T2 signal and restricted diffusion as well as intrinsically high T1 signal in the left caudate nucleus. There is no associated susceptibility effect. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Brain and Neck MRA: There is no evidence of significant steno-occlusive lesions. There is no evidence of cerebral aneurysms.Brain MRV: The images are markedly degraded by patient motion. However, there is no evidence of venous sinus thrombosis based on the conventional brain MRI sequences.
1. Findings compatible with subacute left basal ganglia and coronal radiata infarction. A punctate focus of high T1 signal in the left caudate nucleus infarct is nonspecific and does not appear to represent hemorrhage due to the lack of corresponding susceptibility effect. A metastases is also an unlikely consideration. Nevertheless, follow up with a repeat brain MRI in one month or so may be useful.2. No evidence of significant steno-occlusive lesions in the head and neck arteries. 3. No evidence of venous sinus thrombosis.