65 years Female (DOB:10/24/1950)Reason: patient with h/o cva, meningioma, here with worsening aphasia, want to r/o other acute strokes History: aphasiaPROVIDER/ATTENDING NAME: JOAN C MIEDEMA ANTON M CHIVU There is encephalomalacia involving the left parietal lobe as well as the adjacent left precentral gyrus, left superior temporal gyrus and adjacent left cuneus. There is associated ex vacuo effect along the left lateral ventricle. There is associated volume loss along the left cerebral peduncle and left pons. There is loss of volume of the left thalamus associated with T2 and FLAIR signal hyperintensity posteriorly and laterally.An extra-axial mass which insinuates itself into the left sylvian fissure measuring 20 x 24 mm axial dimensions.Punctate foci of T2 and FLAIR signal hyperintensity along the right cerebellar hemisphere.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is encephalomalacia involving the left parietal lobe as well as adjacent portions of the left frontal, temporal and occipital lobes. This associated with Wallerian degeneration.2.Left thalamic lesion likely is related to a prior vascular event.3.There is no evidence for acute ischemic cerebral infarction.4.Left middle cranial fossa extra-axial mass most likely represents a meningioma.5.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. Additional punctate lesions are present in the right cerebellar hemisphere which are also likely vascular related.