 There are extensive areas of T2 hyperintensity and restricted diffusion in a gyriform pattern involving left anterior frontal and left parietal lobe. Additional small scattered foci of diffusion abnormality are present throughout the bilateral cerebral hemispheres, bilateral caudate nuclei, left anterior corpus callosum, and perhaps in the left superior cerebellum. Many of these areas also demonstrate associated enhancement. There are punctate foci of encephalomalacia in the left cerebellum. The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There may be minimal petechial hemorrhage in the left parietal region, but no gross acute intracranial hemorrhage. There is mild mucosal thickening in the left maxillary sinus as well as trace mucosal thickening in the ethmoid sinuses.
Extensive gyriform restricted diffusion in the left anterior frontal lobe and parietal lobe and several scattered left more than right punctate diffusion abnormality in the cerebral hemispheres, bilateral caudate nuclei, and left cerebellum. These findings are compatible with predominantly early subacute ischemic infarcts in watershed distributions, without gross hemorrhagic transformation or midline shift. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.