38-year-old female with a history of ALL with new right sided hemiparesis, prior MCA stroke with left side hemiparesis one month ago. Also exclude leukemic meningitis. Compared to prior MRI, there is slight interval increase in FLAIR signal abnormality involving the right inferior frontal lobe and anterior insula compatible with evolution of infarct. There is enhancement in the infarcted region compatible with the subacute age. An additional punctate focus of FLAIR signal abnormality and enhancement in the right posterior frontal lobe corresponds to an additional focus of diffusion abnormality present previously and also compatible with subacute infarct. Nodular focus of enhancement along the right caudate head is also favored to represent subacute ischemia. There is punctate focus of susceptibility at the right frontal operculum which may represent minimal prior hemorrhage associated with the infarct.There is no evidence of acute infarct on the current study. No intracranial mass or mass effect. There is no abnormal parenchymal or meningeal enhancement to indicate infection. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.No evidence of acute infarct. No imaging evidence of infection or intracranial leukemia but would suggest correlation with lumbar puncture.2.Expected evolution of the recent infarcts involving the right inferior frontal lobe and insula with additional punctate foci in the right MCA distribution as described above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.