Hemiplegia, unspecified affecting left nondominant side [G81.94], Reason for Study: ^Reason: pt with hx of CVA, L sided weakness History: L sided weakness Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion.There are scattered FLAIR/T2 high signal intensity lesions on periventricular white matter and centrum semiovale indicating nonspecific small vessel ischemic disease. Encephalomalacia is seen on the right frontal lobe middle and inferior frontal gyri are seen indicating right MCA territory chronic ischemic infarct.Multifocal susceptibility lesions are seen on gradient echo images involving bilateral hemispheres indicating chronic petechial hemorrhages or parenchymal calcifications.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Right PCAs are fetal origin. Left P-comm artery and a common artery are patent.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Chronic right frontal lobe middle and inferior gyri ischemic infarction at the territory of right MCA.3. Nonspecific small vessel ischemic disease.4. Multifocal bihemispheric petechial chronic parenchymal hemorrhages or calcification.5. No evidence of flow-limiting intracranial arterial stenosis. No aneurysm.