Female, 74 years old, with right-sided weakness. Corresponding to the area of abnormality noted on prior CT, there is restricted diffusion involving the left operculum and insula, as well as the left frontoparietal junction, with smaller scattered foci of diffusion restriction in the left anterior frontal lobe, the temporal lobe and the occipital lobe. Mild T2 hyperintensity is seen corresponding to these areas of restricted diffusion. No significant generalized mass effect is detected. There may be minimal petechial blood product in the infarct region but no frank hemorrhagic conversion is seen.Elsewhere, scattered foci of T2 hyperintensity are seen within the cerebral hemispheres appearing similar to those noted on prior MRI. No abnormal fluid collections are detected. The ventricular system is normal in size and morphology.Abrupt occlusion of the inferior division of the left MCA is seen within the sylvian fissure. No other significant intracranial stenosis is suspected. No aneurysms are detected within the limitations of technique. The region of the ACOM artery is unremarkable. Prominent bilateral PCOM arteries are seen.In the neck, there is moderate narrowing of the right carotid bifurcation but no significant stenosis by NASCET criteria. The carotid system is otherwise unremarkable. The vertebral vessels of the neck are likewise free of significant vascular stenosis.
1.Findings compatible with acute left MCA stroke fusion infarction. No significant generalized mass effect or frank hemorrhagic conversion is seen.2.Abrupt occlusion of the inferior division of the left MCA is seen. Elsewhere, no significant intracranial vascular stenosis is detected.3.No significant vascular stenosis is seen in the neck.