Encephalopathy, unspecified [348.30], Reason for Study: ^Reason: Stem cell transplant patient with encephalopathy. History: flaccid There are restricted diffusion lesions on the posterior aspect of the left temporal superior, middle and a bit of inferior temporal gyri indicating acute ischemic infarction. There is relatively well marginated high signal intensity lesion on T1 weighted image with susceptibility artifacts on gradient echo images on the left subcentral gyrus and inferior aspect of the post-central gyrus indicating subacute hemorrhagic lesion with surrounding edema. The lesion could be hemorrhagic conversion of acute ischemic infarction considering the subacute hemorrhage area is slightly smaller than surrounding restricted diffusion lesion.There is no abnormal enhancement.There is a small susceptibility lesion on the right centrum semiovale which may indicate non specific such as either parenchymal calcification or chronic petechial hemorrhage.Underlying brain shows minimal to mild non specific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Acute ischemic stroke on the left posterior temporal lobe, superior, middle and inferior temporal gyri.2. Subacute intracerebral hemorrhage on the left subcentral gyrus and inferior aspect of the left post central gyrus as described above. This lesion could represent hemorrhagic conversion of acute ischemic stroke.3. No abnormal enhancement was seen.4. Minimal non specific small vessel ischemic disease.