Multiple hypodensities on CT involving splenium corporis callosum c/f demyelination versus embolic stroke: mild left hemiparesis, fatigue. MRI Brain: There are multiple areas of restricted diffusion in the right cerebral hemisphere, including the right occipital lobe, right corona radiata, cortex of the post central gyrus, and splenium of the right corpus callosum. These lesions display abnormal high T2 signal. There is also enhancement associated with the occipital and right corpus callosal lesion. There is no evidence of intracranial hemorrhage or mass. The pituitary gland appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA Brain: The right posterior cerebral artery is occluded distal to the origin of the posterior communicating artery (P2). There also appears to be focal narrowing of the distal left posterior cerebral artery P1 segment. There is also focal loss of flow related enhancement in the distal right M1 middle cerebral artery segment. The rest middle and anterior cerebral arteries appear to be patent. The intracranial internal carotid arteries demonstrate no significant stenosis. The vertebral arteries, and basilar arteries also are patent with no significant stenosis. There is no evidence of aneurysms or vascular malformations.MRA Neck: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. There is no evidence of stenosis or occlusion. There appear to be several small thyroid nodules.
1. Findings compatible with multiple right cerebral hemisphere subacute infarcts involving multiple vascular territories.2. The right posterior cerebral artery is occluded distal to the origin of the posterior communicating artery (P2) and distal right M1 middle cerebral artery segment.3. No significant steno-occlusive disease in the neck arteries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.