Diagnosis: Other symptoms and signs involving the musculoskeletal system Other symptoms and signs involving the musculoskeletal systemDiagnosis Edits: Clinical question: stroke?Signs and Symptoms: right sided weakness A punctate focus of diffusion restriction is present in the right cerebellar hemisphere. There is a focus of diffusion restriction measuring 36 x 9 mm axial dimensions centered in the left postcentral gyrus with a small amount of associated involvement of the precentral gyrus. There is associated FLAIR signal abnormality presentThere is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.There are multiple small punctate foci of T2 and FLAIR signal hyperintensity present in the basal ganglia and brainstem which are not associated with diffusion restriction.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.A small cystic lesion is present in the right parotid gland posteriorly measuring 10 x 9 mm in coronal dimensions it is high signal on FLAIR MRI and T1 MRI. A smaller such lesion is present along the anterior aspect of the right parotid gland.Exam is mildly degraded due to patient motion which may obscure more subtle abnormalities.
1.Findings are compatible with subacute infarction involving part of the left postcentral gyrus and a small component of the left precentral gyrus.2.A punctate focus of infarction is present in the right cerebellar hemisphere.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 4.There are some patchy lesions in the brainstem, cerebellum and basal ganglia which are likely vascular related.5.Exam is mildly degraded due to patient motion which may obscure more subtle abnormalities.6.A couple small complex cystic lesion is present in the posterior aspect of the right parotid gland. A follow-up exam may be helpful.