Female, 42 years old, with left-sided stroke presenting with slowed response, concern for worsening mental status. Barely detectable diffusion restriction is seen corresponding to the areas of hypoattenuation noted on prior CTA involving the left insula, opercular tissues and inferior parietal lobule. No significant edema, mass effect or volume loss is evident as of yet. Trace scattered sulcal FLAIR hyperintensity within the infarct region may reflect vascular engorgement or slow flow.Scattered small foci of cortical and white matter T2 hyperintensity are seen which may reflect prior episodes of ischemia. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. Several scattered foci of susceptibility are seen which may reflect chronic microhemorrhage. The ventricles are normal in size and morphology.
1.Diffusion restriction corresponding to the known left MCA infarct is barely detectable suggesting a subacute time course. 2.No evidence of associated edema, mass effect or significant tissue loss is detected.3.No other acute findings are seen to account for the patient's apparent worsening mental status.