38 years Female (DOB:2/13/1978)Reason: 38F AML/ALL, recent R MCA stroke (11/19) s/p TPA/thrombectomy, now with blurred vision and HA and CT head with evolving R MCA ischemia. eval for new foci of ischemia vs evolution of old stroke History: 38F AML/ALL, recent R MCA stroke (11/19) s/p TPA/thrombectomy, now with blurred vision and HA and CT head with evolving R MCA ischemia. eval for new foci of ischemia vs evolution of old strPROVIDER/ATTENDING NAME: CHRISTOPHER K. DAUGHERTY Brain MRIThere are redemonstration of scattered restricted diffusion involving right frontal lobe, insular cortex caudate head and right temporal lobe. These lesions suggest evolving right MCA territory subacute ischemic stroke without evidence of hemorrhagic conversion.Comparing to prior MRI, the extent of the restricted diffusion appears to be similar.The ventricles, sulci and cisterns are unremarkable. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. In particular, there is no evidence of focal filling defect which was seen on prior CT angiogram.Neck MRA3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. Evolving right MCA subacute ischemic stroke without evidence of hemorrhagic conversion. 2. No evidence of new acute ischemic or hemorrhagic lesion.3. Normal brain and neck MRA.