Clinical question: Seizure versus embolic stroke. Signs and symptoms: Right arm jerking 5 minutes. Nonenhanced brain MRI:There is excessive motion artifact throughout the images. Study is suboptimal however diagnostic.Diffusion-weighted images are negative and no evidence of acute ischemic stroke is detected.Examination demonstrates patchy nonspecific foci of flair hyperintensity in the subcortical and periventricular white matter of bilateral cerebral hemispheres which considering patient's stated age of 87 likely representing chronic microvascular ischemic changes. The signal intensity of brain parenchyma is otherwise unremarkable.There is slight prominence of cortical sulci and ventricular system which may be at the upper limits of normal for patient stated age.Signal void of major intracranial arterial branches are identified.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.Calvarium and soft tissues of the scalp are unremarkable.
1.No acute intracranial process.2.Findings suggestive of mild chronic non-hemorrhagic small vessel ischemic strokes.3.Unremarkable suboptimal motion degraded exam otherwise.