Other specified disorders of muscle [M62.89], Reason for Study: ^Reason: evaluate for intracranial mass History: R sided numbness, word finding difficulty. Multifocal scattered left frontal lobe diffusion restriction lesions were seen without evidence of susceptibility artifacts indicating acute ischemic stroke.Underlying brain shows patch bihemispheric periventricular white matter FLAIR/T2 high signal intensity lesions indicating nonspecific small vessel ischemic disease, unchanged.On gadolinium enhanced scan, especially medial aspect of the left frontal lobe shows gyral pattern vascular enhancement again consistent with acute vascular territorial (left anterior cerebral artery) ischemic stroke.Lobulating contoured nonenhancing right parotid deep lobe mass is again seen, measured size was 23 mm x 9.6 mm, unchanged.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Small retention cyst on the left maxillary sinus.
1. Acute ischemic stroke without evidence of hemorrhagic conversion at the left frontal lobe as described above.2. Unchanged underlying nonspecific small vessel ischemic disease.3. Unchanged right deep parotid gland correlating contour not enhancing lesion since prior scan.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.