right hand numbness and slurred speechspeech disturbanceClinical question: stroke The CSF spaces are appropriate for the patient's stated age with no midline shift. There are several punctate foci of diffusion restriction scattered in the watershed zone in the left hemisphere. Additionally a punctate focus of diffusion restriction is present in the right centrum semiovale. Several other punctate foci of diffusion restriction are present in the left caudate nucleus and the left putamen.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There are punctate foci of cerebral infarction in the left and right hemispheres but no large infarction. Bilaterality and tiny size of infarcts suggests these are possibly due to a small shower of emboli.