89 years Female (DOB:7/10/1926)Reason: stroke eval History: r weakness, NIHSSS=22, ASPECTS =2PROVIDER/ATTENDING NAME: MICHAEL A WARD MICHAEL A WARD MRI of the brainThere is a large area of diffusion restriction present in the left middle cerebral artery territory which involves the full extent of the left middle cerebral artery territory as well as left internal capsule and left caudate nucleus..There is susceptibility effect present within the left distal internal carotid artery and proximal left middle cerebral artery.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.MRA brain:Antegrade flow is present in the distal right internal carotid artery, the distal left vertebral artery, the basilar artery and the proximal anterior, right middle and posterior cerebral arteries. The right posterior cerebral artery has fetal origin. Anterior communicating artery is small. The left posterior communicating artery is identified and demonstrates minimal flow into the left anterior cerebral artery territory.There is no flow identified in the left vertebral artery in the distal right vertebral artery.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.Left ICA occlusion2.Large left MCA and anterior choroidal territory acute ischemic infarction3.Findings suggest occlusion of the distal right vertebral artery