56 years Female (DOB:7/9/1959)Reason: ischemic lesion History: right sided weaknessPROVIDER/ATTENDING NAME: JAMES A MASTRIANNI JAMES A MASTRIANNI Small foci of diffusion restriction are present in the left middle frontal gyrus as well as the left pre- and post central gyrus including the left hand motor area. These are associated with FLAIR and T2 signal hyperintensity.There are left-sided periventricular white matter lesions present which are high signal on T2 and FLAIR MRI as well as some cortically based FLAIR and T2 foci of signal hyperintensity along the medial aspect of the left middle frontal gyrus and along the left postcentral gyrus.No abnormal 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 right 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 left internal carotid artery flow-void is absent in the petrous segment but can be identified in the cavernous and ophthalmic segments.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 watershed distribution small foci of infarction along the left middle frontal gyrus and left pre and postcentral gyrus which aren't in the acute phase. In addition there are chronic phase watershed infarctions in the left frontal lobe.2.Findings suggest left ICA occlusion with collateral reconstitution.