Carotid stenosis: headache left sided weakness. MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is encephalomalacia in the right parietal and posterior right frontal lobes, with a few small scattered areas of susceptibility effect. There is a background of scattered cerebral and pontine white matter T2 hyperintensity. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA: There is significant stenosis at the origin of the right carotid artery with markedly diminutive flow-related enhancement throughout the right internal carotid artery, but flow is reconstituted at the circle of Willis. There is no evidence of other significant steno-occlusive lesions in the head and neck arteries. There is no evidence of cerebral aneurysms.
1. Chronic right cerebral hemisphere infarcts and small vessel ischemic disease, but no evidence of acute intracranial hemorrhage, mass, or acute infarct.2. Significant stenosis at the origin of the right carotid artery with diminutive flow-related enhancement throughout the right internal carotid artery. 