Reason: 81 yo F with recent CVA 1 week ago at St. Bernard Hospital p/w mental status changes, evaluate for evolving CVA History: R sided weakness, AMS There is diffusion restriction present which involves the medial aspect of the left parietal lobe, the posterior aspect of the left paracentral lobule and adjacent left cingulate gyrus and corpus callosum.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Punctate lesions are present in the thalami and basal ganglia.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Subacute infarction involving the territory of the left superior internal parietal artery as detailed above.2.Periventricular and subcortical white matter changes as well as lesion in the basal ganglia and thalami of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.The exam is significantly degraded by patient motion. This would obscure more subtle abnormalities. and precluded acquisition of susceptibility imaging and postcontrast imaging