Male, 56 years old, history of stroke with right hemiplegia and left ICA stenosis. MRI:Areas of restricted diffusion seen previously within the left centrum semiovale and insula have resolved. No new areas of restricted diffusion are demonstrated.A right frontal approach ventricular catheter is in place with its tip in the right frontal horn, approximately unchanged relative to the prior examination. Ventricular size and morphology are unchanged including ex vacuo dilatation of the right atrium.Encephalomalacia of the right parietal lobe is unchanged compatible with history of prior treated AVM. Encephalomalacia of the right frontal lobe is also unchanged. Extensive patchy periventricular and brainstem T2 hyperintensity is redemonstrated, largely unchanged with the exception of the left centrum semiovale where it has likely progressed to some degree.Susceptibility artifact is seen along the right frontal ventricular catheter likely related to chronic blood product. Susceptibility within the right parietal lobe is also seen compatible with prior treatment and chronic blood product. No evidence to suggest acute intracranial hemorrhage is seen.MRA:Scattered moderate to severe stenoses are again seen along the distal left M1 segment, the level of the MCA bifurcation and involving the left anterior temporal artery, similar to that seen on the prior examination. The basilar artery demonstrates scattered moderate stenoses also similar to prior.A 3-mm aneurysm arising from the basilar tip has likewise not significant changed in size or morphology.
1. Resolution of acute ischemia seen previously within the left centrum semiovale and insula. There is new corresponding T2 hyperintensity of the involved white matter.2. Encephalomalacia of the right parietal lobe, with evidence of prior AVM treatment, as well as encephalomalacia of the right frontal lobe and patchy white matter/brainstem signal abnormality, all unchanged.3. Stable MRA of the brain with no significant interval change in the appearance of scattered stenoses in the proximal left MCA distribution, or of a 3-mm aneurysm arising from the basilar tip.