59 years, Female, with bilateral lower extremity myoclonus. There are foci of restricted diffusion in the left frontal lobe, predominantly in the middle left frontal gyrus, with a small focus also including the lateral aspect of the precentral gyrus. Additional tiny foci of restricted diffusion are present in the left parietal lobe. There is associated T2/FLAIR signal hyperintensity in these regions. A tiny focus of gradient susceptibility is present within the left frontal lobe infarct, which may represent thrombus versus minimal petechial hemorrhage. No frank intraparenchymal hemorrhage or additional intracranial hemorrhage is identified. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
Acute infarcts in the left frontal and left parietal lobes. Tiny focus of susceptibility within a left frontal infarct may be related to minimal petechial hemorrhage versus thrombus within a distal middle cerebral artery branch. No frank intraparenchymal hematoma. No intracranial mass effect.Dr. Sorensen discussed the above findings with Dr. Liu at 1345 hours on 8/7/2016.