Reason: assess infarct size History: Patient s/p mechanical thrombectomy on 2/22/2016 There is restricted diffusion in the left MCA territory particularly in the cortex of left frontal and parietal lobes, basal ganglia, and insula. There is surrounding edema and hemorrhage with mass effect on the anterior horn of the left lateral ventricle. There is trace rightward midline shift at the level of the foramen of Monro. There is also focus of restricted diffusion in the left cerebellar hemisphere. There are additional foci of FLAIR hyperintensities in the right cerebellum and left cerebral peduncle without restricted diffusion suggestive of chronic ischemia. There is volume loss involving the left occipital lobe with mild FLAIR hyperintensity suggestive of chronic infarct with ex vacuo dilatation of the occipital horn of the left lateral ventricle. There are suspected acute subarachnoid blood products in the left sylvian fissure as seen on recent CT.Major flow voids are maintained. There is nonspecific opacification of the ethmoid air cells, left maxillary sinus, and bilateral sphenoid sinuses with air-fluid level. Mastoid air cells are clear. Imaged orbits are intact.
1.There is restricted diffusion consistent with acute infarct predominantly in the left MCA territory as described above. There is hemorrhagic transformation involving the left basal ganglia component of the infarct with surrounding edema and mass effect on the lateral ventricle with trace midline shift.2.There is tiny left cerebellar acute infarction.3.Suspected subarachnoid blood products in the left sylvian fissure which were also seen on recent CT.4.Chronic left occipital infarct.