Female, 54 years old, with seizures and history of strokes. MRI brain:A band of encephalomalacia is seen involving the posterior left middle frontal gyrus, the left centrum semiovale and left parietal and occipital lobes, all within the MCA distribution. A small chronic cortical infarct is evident within the right inferior parietal lobule.No evidence of parenchymal edema or mass effect is seen. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. Apart from ex vacuo dilatation of the left lateral ventricular atrium, the ventricles are within normal limits.MRA brain:A slight paucity of left MCA M3 and M4 branches is noted relative to the right. Otherwise, no significant intracranial vascular abnormalities are observed. No aneurysm or vascular malformation is detected. The ACOM artery is moderately sized and unremarkable. Prominent bilateral PCOM arteries are evident.MRA neck:No significant vascular stenosis is detected in the carotid vessels of the neck by NASCET criteria. No significant vascular stenosis is detected in the vertebral vessels.
1.Evidence of a large chronic left MCA distribution infarct with a small right parietal lobe chronic infarct.2.No acute ischemia or other acute intracranial abnormalities are detected.3.Slight paucity of distal left MCA vessels is compatible with the chronic infarction in this distribution. Otherwise, no significant intracranial vascular lesion is detected.4.No significant vascular lesion is seen in the neck.