Essential (primary) hypertension [I10] / Headache [R51], Reason for Study: ^Reason: concern for possible stroke on CT, further eval needed History: HTN emergency, Headache Multifocal scattered diffusion restriction lesions on the right hemisphere involving right frontal, parietal, temporal and occipital lobes indicating acute ischemic infarct. There is no evidence of acute hemorrhagic lesion.Right side periventricular white matter extended toward the right side basal ganglia showed high signal intensity on FLAIR imaging indicating prior ischemic infarct related lesion. There are multiple scattered FLAIR/T2 high signal intensities on bilateral centrum semiovale and periventricular white matter indicating nonspecific but likely chronic ischemic infarct related lesions.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or 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 and opacification are seen especially on the left maxillary sinus and left anterior ethmoid sinus
Multifocal acute ischemic infarct on the right hemisphere as described above.Underlying brain shows multifocal chronic ischemic changes.There is no evidence of acute ischemic or hemorrhagic lesion.