Weakness [R53.1], Reason for Study: ^Reason: Eval stroke vs MS flare - please use MS protocol in addition to cuts History: L face/arm/leg weakness There is focal restricted diffusion on the right side posterior aspect of basal ganglia extends toward periventricular white matter and external capsule without evidence of hemorrhagic transformation indicating acute ischemic infarct.Underlying brain shows multifocal scattered periventricular and deep white matter FLAIR/T2 high signal intensity lesions on bilateral hemisphere as well as brain stem which is consistent with the patient's known demyelinating disease such as multiple sclerosis. Comparing to prior scan performed at outside hospital, there is no significant interval change of FLAIR/T2 high signal intensity lesions.There is no evidence of abnormal enhancement.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Acute ischemic infarct involving right posterior aspect of basal ganglia as described above without evidence of hemorrhagic transformation.2. Unchanged scattered multifocal bihemispheric, supra and infratentorial FLAIR/T2 high signal intensity lesions consistent with multiple sclerosis.