Aphasia following cerebral infarction [I69.320], Reason for Study: ^Reason: s/p L mca History: L mca , global aphasia Brain MRI:There is evidence of restricted diffusion on the left frontal and parietal lobes as well as insular cortex and left side basal ganglia with some susceptibility effect especially on the left insular cortex and basal ganglia indicating acute/subacute ischemic infarct with focal hemorrhage transformation.Tubular susceptibility lesion on the left sylvian fissure indicating left MCA with thrombus.There is evidence of minimal midline shift toward the right side measured about 1 to 2 mm at the level of foramen of Monro.The ventricles, sulci and cisterns are symmetric and unremarkable. The cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Bilateral maxillary sinus shows mucosal thickening, in addition, there is a air-fluid level on the right maxillary sinus.Brain MRA:3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate complete occlusion of left MCA proximal M1 segment.Otherwise bilateral ICA, bilateral ACAs and vertebrobasilar system appear to be normal.
1. Acute/subacute ischemic infarct on the left MCA territory with focal hemorrhagic transformation especially on the left side facial cortex and basal ganglia as described above with minimal mass effect.2. MR angiogram shows complete occlusion of the left MCA proximal M1 segment just after the left ICA bifurcation. 