Nontraumatic subarachnoid hemorrhage, unspecifiedClinical question: Please evaluate for new infarct or other abnormality to explain SAHSigns and Symptoms: Post-R carotid stent for aneurysm (11/2 then 11/11, with acute/subacute infarcts at the time), new SAH There is susceptibility effect, sulcal FLAIR signal hyperintensity and T1 signal hyperintensity suggestive of subarachnoid blood present along the the right sylvian fissure, the right superior temporal sulcus, the right middle temporal sulcus, the right inferior temporal sulcus, and the lateral aspect of the right posterior central sulcus. A small amount of intraventricular blood is also present.There is redemonstration but decrease in size of diffusion restriction along the right precentral gyrus with. Other foci of diffusion restriction identified on the prior exam at the anterior aspect of the insular cortex and in the parietal lobe are less conspicuous on DWI but evident on FLAIR.Normal vascular flow voids are present in the distal 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 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.There is a covered stent with flow void coursing through a now thrombosed right upper neck pseudoaneurysm.
1.Subarachnoid blood is centered along the right Sylvian fissure, the right superior temporal sulcus, the right middle temporal sulcus, the right inferior temporal sulcus, and the lateral aspect of the right posterior central sulcus. 2.Continued evolution of small foci of infarction along the right precentral gyrus, right parietal lobe and right insular cortex.