Dysarthria and vomiting. Evaluate for posterior circulation stroke. Brain MRI: There is an area of diffusion restriction and increased T2 signal in the right cerebellar hemisphere that measures up to 16 mm. There is also a punctate focus of diffusion restriction in the superior right postcentral gyrus. There are a few tiny scattered T2 hyperintense foci in the cerebral white matter that most probably reflect mild chronic microvascular ischemia. There is no evidence of intracranial mass lesions or hemorrhage. There is no midline shift or ventricular dilatation. The orbits and paranasal sinuses are unremarkable. The skull and scalp soft tissues are also grossly unremarkable.Brain MRA: There is no evidence of significant steno-occlusive lesions or aneurysms.Neck MRA: There is no evidence of significant steno-occlusive lesions. The right internal carotid artery has a retropharyngeal course.
1. Foci of diffusion restriction in the right cerebellar hemisphere and right postcentral gyrus are compatible with acute infarcts. 2. No evidence of significant steno-occlusive lesions in the head and neck arteries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.