Encephalopathy, unspecified [G93.40], Reason for Study: ^Reason: Persistently encephalopathic with R gaze deviation and R sided weakness History: pls see above Multifocal scattered bihemispheric restricted diffusion lesions involving bilateral frontal, parietal temporal, left occipital bilateral basal ganglia and bilateral cerebellar hemisphere indicating acute ischemic infarct.There is also 53.7 mm (AP) x 30.2 mm (RL) x 15 mm (CC) sized left basal ganglia acute/subacute ICH with the surrounding edema and mass effects. There is midline shift toward the right side about 8 mm at the level of foramen of Monro measured on axial scan. Considering underlying multifocal acute ischemic infarcts, this hemorrhagic lesion could demonstrate hemorrhagic conversion.Underlying brain shows patch scattered bihemispheric periventricular white matter FLAIR/T2 high signal intensity lesions indicating nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. Mucosal thickenings on bilateral maxillary sinuses, ethmoid sinuses, sphenoid sinus and frontal sinus. Bilateral mastoid air cells show opacifications.
1. Multifocal supra and infratentorial ischemic infarctions.2. Left basal ganglia ICH with mass effects with midline shift toward right side, likely represent hemorrhagic conversion.3. Underlying non specific small vessel ischemic disease.