Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus [G40.309] / Weakness [R53.1], Reason for Study: ^Reason: evaluate for poss met, vs post infarct encephalomalacia History: Status epilepticus on presentation There is no evidence of acute ischemic lesion.However, there is late subacute ischemic infarction involving left occipital lobe cuneus with minimal surrounding edema but without diffusion restriction. On post contrast scans, the lesion shows gyriform enhancement indicating luxury perfusion status. On gradient echo images, the left occipital lobe lesions show punctate susceptibility artifacts indicating hemorrhagic transformation.In addition, there are multifocal chronic ischemic infarct lesions involving left inferior parietal lobule and right occipital lobes, in particular cuneus and anterosuperior aspect of lingual gyrus. There is no evidence of abnormal nodular enhancement suggesting possible metastatic nodule on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Mucosal thickening on the right maxillary sinus.
1. Late subacute ischemic infarct lesions involving left occipital lobe cuneus as described above.2. Chronic ischemic infarctions involving right inferior parietal lobule as well as right occipital lobes as described above.3. No evidence of acute ischemic or hemorrhagic lesion.