Cerebral infarction, unspecified [I63.9] / Other specified soft tissue disorders [M79.89], Reason for Study: ^Reason: Evaluate etiology of comatose state History: comatose state Brain MRIMultifocal various sized restricted diffusion lesions on bilateral hemispheres including bilateral centrum semiovale, left temporo-occipital lobe, right side caudate nucleus, bilateral temporal lobes, bilateral basal ganglia, left cerebellar hemisphere and right middle cerebellar peduncle indicating acute ischemic infarctions.There is susceptibility lesion on the right temporal lobe indicating acute intracerebral hemorrhage, considering multifocal ischemic infarctions, this lesion could represent hemorrhagic transformation.There are also scattered susceptibility lesions on bilateral hemispheres indicating multiple petechial hemorrhages or multiple cavernous malformations or parenchymal calcifications.The ventricles, sulci and cisterns are symmetric and unremarkable. The mastoid air cells are clear.Mucosal thickening on bilateral ethmoid sinuses and right maxillary sinus. Brain MRA3D 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.Brain MRVThis is non diagnostic brain MRV. Thus, if clinically indicated, the exam needs to be repeated without additional charge.There is definitive evidence of major dural sinus occlusion.
1. Multifocal various sized bihemispheric, supra and infratentorial acute ischemic infarctions with right temporal ICH. The ICH could represent hemorrhagic conversion.2. Normal brain MRA.3. Non diagnostic MRV but major dural sinuses appear to be patent. 