Other disturbances of skin sensation [R20.8], Reason for Study: ^Reason: acute ischemia History: left arm weakness Brain MRIThere are multiple focal restricted diffusion on the left frontal lobe indicating acute ischemic infarction without evidence of hemorrhagic conversion. Underlying brain shows scattered patchy FLAIR high signal intensities on periventricular white matter and centrum semiovale indicating non specific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. Right Pcom is patent and Acom is also patent. The left Pcom is not seen.Neck MRA3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. Left vertebral artery is hypoplastic.
1. Acute ischemic infarction on the left frontal lobe without evidence of hemorrhagic conversion.2. Underlying non specific small vessel ischemic disease.3. Normal Brain MRA.4. Normal Neck MRA. 