Right-sided weakness. Evaluate for hemorrhagic conversion. Reidentification of patchy asymmetric hypoattenuating area along the distribution of the left MCA corresponding to abnormality seen on MRI of 12/12/2010 and CT perfusion on 12/11/2003 is compatible with stroke. Peri-ventricular and subcortical white matter hypoattenuating foci bilaterally are consistent with chronic small vessel ischemic disease appearing similar to prior exam.Prominence of extra-axial spaces and ventricular system is compatible with parenchymal volume loss. No extra-axial fluid collections, mass, or hemorrhage. Diffuse sclerosis involves the calvarium. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
1. Left MCA infarct as previously described without evidence of hemorrhagic conversion.2. Small vessel ischemic disease and other findings appearing similar to prior exam.