Aphasia [R47.01], Reason for Study: ^Reason: eval for stenosis History: aphasia Brain MRIMultifocal restricted diffusion lesions on the left hemisphere including left frontal lobe superior and middle frontal gyri, left insular cortex, and left frontal operculum indicating acute ischemic infarction. There is no evidence of hemorrhagic conversion. Underlying brain shows patchy FLAIR high signal intensity lesions on bilateral periventricular white matter indicating non specific small vessel ischemic disease.The 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. 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.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate no evidence of arterial luminal stenosis, no arterial aneurysm on bilateral ICAs, MCAs, ACAs and vertebrobasilar system.Neck MRAMotion artifacts degraded examination quality.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate no evidence of significant (more than 50%) of luminal narrowing of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins appear to be normal but tortuous proximal bilateral vertebral arteries. There is no evidence of luminal stenosis in the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. Multifocal left MCA territorial acute ischemic strokes without evidence of hemorrhagic conversion as described above.2. No evidence of significant arterial luminal stenosis on both intracranial and extracranial craniocervical arterial system. 