Right upper extremity weakness, hyperreflexia, and multiple falls. There are scattered foci of cortical and subcortical high T2 signal with restricted diffusion as well as punctate enhancement in the left frontal and parietal lobes in a distribution that coincides with the ACA-MCA watered territory. There is no evidence of intracranial hemorrhage, mass, or midline shift. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is extensive mucosal thickening and secretions within the left maxillary and sphenoid sinuses. There is fluid and enhancement within the left mastoid air cells.
1. Subacute infracts in the left ACA-MCA watered territory, without midline shift or hemorrhagic transformation.2. Findings suggestive of acute sinusitis and mastoiditis.