Nontraumatic intracerebral hemorrhage in hemisphere, unspecified [I61.2], Reason for Study: ^Reason: eval ?meningioma, etiology of ICH History: left weakness Brain MRI:There is evidence of restricted diffusion on the right occipital lobe indicating acute ischemic infarct. In addition, there is a linear circumscribing susceptibility effects around the restricted diffusion area which suggest prior hemorrhage. The right occipital lobe shows volume loss with surrounding white matter high signal intensity on FLAIR images indicating chronic ischemic infarction. There is 34mm x 33mm x 33mm sized right frontal ICH with surrounding edema and mass effects.Underlying brain shows patchy high signal intensities on periventricular white matter and centrum semiovale indicate non specific small vessel disease.There is about 20mm x 22mm x 17.5mm sized anterior cranial fossa meningioma. No change since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA:3D 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.Neck MRA:3D 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 right vertebral artery origin shows about 50% of luminal stenosis and the left vertebral artery origin appears to be normal.
1. Acute ischemic infarction within the area of chronic ischemic infarction with chronic hemorrhages on the right occipital lobe.2. Acute ICH on the right frontal lobe with surrounding edema and mass effects.3. No change of anterior cranial fossa meningioma since prior scan.4. No fluid limiting luminal stenosis on both intracranial and extracranial arterial system. No intracranial arterial aneurysm. 