Female, 72 years old, with aphasia and right facial droop, suspected left MCA syndrome.] For stroke. Gyriform restricted diffusion is evident within the lower left precentral gyrus and middle frontal gyrus. There may be a small focus of restricted diffusion within the left postcentral gyrus as well. Very mild patchy cortical restricted diffusion is also suspected along the left temporal and occipital junction.Sequelae of prior ischemia are seen within the left temporal and occipital lobes with associated gliosis and encephalomalacia. There is mild ex vacuo dilatation of the left ventricular atrium. Numerous scattered foci of periventricular white matter T2 hyperintensity are also seen compatible with chronic microvascular ischemic disease.No evidence of significant generalized mass effect is seen. No findings to suggest acute intracranial hemorrhage are noted. Several scattered foci of susceptibility are seen predominantly in the left cerebral hemisphere compatible with chronic microhemorrhage. Except as above, the ventricles are within normal limits.
1.Acute ischemia involving the lower left precentral gyrus and part of the left middle frontal gyrus. There may be an additional small focus of acute ischemia within the left postcentral gyrus, and mild, perhaps subacute ischemia at the left temporal occipital junction.2.Sequelae of multiple prior territorial and small vessel ischemic lesions are seen. No evidence of significant intracranial hemorrhage or any generalized cerebral mass effect is seen.