Right arm and leg weakness. Evaluate for acute infarct. There are multiple foci of restricted diffusion within the left frontal lobe, left frontoparietal corona radiata and centrum semiovale and left parieto-occipital lobe with associated T2 signal abnormality. There is loss of normal flow void of the cervical, petrous and cavernous left internal carotid artery. There is no evidence of intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is moderate mucosal thickening of the right sphenoid sinus. There is partial opacification of the left mastoid air cells. The skull and extracranial soft tissues are unremarkable.
1. Multiple foci of restricted diffusion consistent with acute infarcts within the left cerebral hemisphere in a watershed distribution.2. Loss of normal flow void of the cervical, petrous and cavernous left internal carotid artery, likely representing high-grade stenosis or occlusion. Recommend further evaluation with CTA or MRA.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.