Dysphagia, unspecified(787.20) [787.20], Reason for Study: ^Reason: subacute stroke History: drooling, dysphagia, decreased grip strength Motion artifacts degraded image quality.There is focal enhancing lesion (about 4mm) on the midline to slightly right side of the tectum on T1 Gad enhanced images (series 1201, image 16/32). The lesion shows low signal intensity on T1 non contrast images and slightly high signal intensity on T2 weighted images. On FLAIR images, the lesion area shows CSF signal intensity. There is no evidence of mass effects of this lesion toward adjacent anatomical structure. There is no evidence of susceptibility artifacts on this lesion.Therefore, this lesion could be a partial volume averaging artifacts with tectum area CSF, possibly small pineal cyst and adjacent internal cerebral vein. However, possibility of small tectal glioma or capillary telangiectasia cannot be completely excluded. Repeat MRI scan with thinner section of the lesion with and without contrast enhancement may be considered for further imaging evaluation. There is no evidence of acute ischemic or hemorrhagic lesion on the scan.There is focal encephalomalacia on the left posterior inferior temporal lobe without evidence of susceptibility artifacts indicating chronic ischemic infarction.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Focal enhancing lesions on the tectum as described above, possibilities include partial volume artifacts, tectal glioma, capillary telangiectasia. Repeat exam with thin section around the tectum may be considered for further imaging evaluation.3. Focal encephalomalacia on the left inferior posterior temporal lobe likely represent chronic ischemic infarction, as described above. 