Reason: Evaluate for new infarct. History: Transient left face droop with persistent dysphagia. Known old right-sided strokes. There is an area of restricted diffusion and high T2 signal in the right basal ganglia and corona radiata that measures up to 20 mm. There is no evidence of gross hemorrhagic transformation. There is extensive encephalomalacia in the inferior right cerebellar hemisphere, a small areas of encephalomalacia in the inferior left cerebellar hemisphere, and defects in the bilateral corona radiata and centrum semiovale superimposed upon a background of confluent cerebral white matter T2 hyperintensity. There is diffuse cerebral volume loss. There is no midline shift or herniation. There is a right maxillary sinus retention cyst. There is a partially imaged, but large left parotid gland T2 hyperintense bosselated mass.
1. Acute infarct in the right basal ganglia and corona radiata superimposed upon a background of extensive chronic infarcts and small vessel ischemic disease.2. Partially imaged left parotid mass may represent a pleomorphic adenoma. Dedicated imaging of this region may be useful for further evaluation.Discussed with Dr. Reder at 3:20 PM on 1/15/15.