 Multiple foci of diffusion signal abnormality with only minimal corresponding signal abnormality on the flair consistent with small foci of acute ischemia which are new from the prior exam. Foci of acute diffusion abnormality include two foci in the left occipital cortex, a slightly larger focus in the left insular cortex as well as the adjacent white matter, a single focus in the right frontal lobe, and small focus in the right cerebellar hemisphere. There is a chronic appearing infarct is present in the subcortical white matter of the inferior frontal gyrus (series 303, image 172).Again seen is the posterior parietal lesion, very similar in size the prior exam measuring 2.5 x 2.1 cm (series 501, image 22). Surrounding vasogenic edema is similar to the prior exam dated 1/28/15. No significant mass effect or midline shift. The cerebellar tonsils are in normal position. No appreciable hemorrhage. The ventricles and sulci are normal in size. Flow voids are present within the major vessels indicating patency. Posterior parietal lesion shows enhancement. Postoperative changes are seen secondary to a biopsy of this lesion. No new lesion is identified. Motion limits sensitivity facial MRI. Sinonasal windows present on the right as well is evidence of left chronic sinus disease. There is an air-fluid level in left maxillary sinus, recommend correlation with symptoms of sinusitis. No abnormal enhancement is seen in the face.
1. Multiple foci of diffusion abnormality indicating acute infarct in multiple lobes. There is also a single focus of chronic infarction that is new from the prior exam in the left frontal lobe.2. Right posterior parietal PTLD lesion is not significantly changed. No new lesion is identified.3. Evidence of chronic left sinus disease. Recommend correlation with symptoms of sinusitis. No abnormal enhancement in the face.