66 years, Female, status post left MCA posterior division stroke, status post TPA and embolectomy. Assess stroke burden.. There is restricted diffusion predominantly involving the territory of the posterior division of the left middle cerebral artery including the posterior aspect of the left superior and middle temporal gyri. Additional foci of restricted diffusion are noted in the left insula and subinsular white matter as well as scattered foci involving the left frontal and parietal cortical, subcortical, and deep white matter. These acute infarcts have evolved since CT from 8/16/2015. No evidence of hemorrhagic transformation. No significant mass effect. There is encephalomalacia predominantly involving the right frontal lobe extending to the insular cortex and operculum with minimal component including the right anterior parietal lobe and basal ganglia. There is associated ex vacuo dilatation of the right lateral ventricle. Cavum septum pellucidum and cavum vergae incidentally noted. No hydrocephalus.Additional 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. Remainder of the brain, sella, orbits, and extracranial soft tissues are unremarkable within the limitations of motion degraded exam.
1. Acute infarct in the left MCA territory, predominantly involving the posterior division including the posterior temporal lobe, with additional left hemispheric foci of infarct as described above. No evidence of hemorrhagic transformation or significant mass effect.2. Chronic right MCA territory infarct.