60 years, Male, with recent left hemiplegia, hemineglect, and hemisensory loss secondary to right PCA territory infarct. There is diffusion restriction and increased T2 signal within the right occipital lobe and posterior temporal lobes, which also involves the cuneus, lingual gyrus, and fusiform gyrus. The right thalamus is also involved to a mild degree. Similar areas were identified on CT as having relative hypoattenuation and loss of gray-white matter differentiation. No intracranial hemorrhage, mass or mass-effect is evident. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. Sella and orbits are grossly within normal limits. There is a large mucous retention cyst and some dependent secretions in the left maxillary sinus. Deformity of the right maxillary sinus may be posttraumatic. The paranasal sinuses and mastoid cells are otherwise clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Acute/subacute right posterior cerebral artery territory infarct. No MR evidence of hemorrhagic conversion.2. No evidence of acute intracranial hemorrhage or mass.