Female, 69 years old, with right-sided weakness, concern for ischemia. A small focus of T2 hyperintensity and susceptibility is seen within the left paracentral lobule. T2 hyperintensity and encephalomalacia is also evident more inferiorly along the left postcentral gyrus. In the adjacent left corona radiata, there is a subcentimeter triangular region of T2 hyperintensity with corresponding hyperintense signal on diffusion but no convincing ADC correlate.Elsewhere in the brain, a few scattered very small foci of T2 hyperintensity are seen within the cerebral white matter, a nonspecific finding. No evidence of significant parenchymal edema or mass effect is seen. No evidence of acute intracranial hemorrhage or any abnormal extra axial fluid collection is detected. The ventricular system is normal in size and morphology.
1.Lesions within the left paracentral lobule and left postcentral gyrus are most compatible with small areas of chronic cortical infarction.2.A small region of diffusion signal abnormality within the left corona radiata does not show convincing ADC correlation and may therefore represent T2 shine through artifact from a chronic ischemic insult. This could also, however, reflect late subacute nearly resolved ischemia.