Type II or unspecified type diabetes mellitus without mention of complication, not stated as uncontrolled [250.00], Reason for Study: CT evidence of acute ischemic stroke on the right temporal lobe. There is restricted diffusion on the left posterior aspect of the middle and inferior temporal lobe as well as left parietal lobe precuneus indicating acute to subacute ischemic infarction. On gradient echo images, the lesions show susceptibility artifacts indicating hemorrhagic transformation.There are other subtle restricted diffusion lesions including right frontal lobe middle frontal gyrus, right temporo-occipital gyrus, and left cerebellar hemisphere indicating subacute ischemic infarctions. Underlying brain show multifocal tissue defects on the right parietal lobe superior lobule, left thalamus and left cerebellar hemisphere indicating age indeterminate likely chronic ischemic infarction.There are mild non specific small vessel ischemic disease on FLAIR images.The ventricles, sulci and cisterns are symmetric and unremarkable. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.The sphenoid sinus shows mucosal thickening.The right eyeball lens appears to be very thin indicating possible post-cataract surgery and the right eyeball shows elongated appearance indicating possible staphyloma.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.No intracranial arterial aneurysm was seen.No significant arterial luminal stenosis.
1. Left temporal and parietal lobes acute or subacute ischemic infarctions with hemorrhagic transformation involving left middle and inferior temporal gyrus, left parietal lobe precuneus.2. Multifocal bihemispheric subacute ischemic infarctions as described above.3. Underlying brain shows multifocal chronic ischemic infarctions and non specific small vessel ischemic disease. 4. No intracranial arterial aneurysm. No intracranial arterial luminal stenosis or occlusion.5. Possible post cataract surgery status on the left eye lens and staphyloma on the right eyeball.