Clinical question: Evaluate for ischemic stroke. Signs and symptoms: 69 year old with right upper extremity weakness, dysarthria, possible right facial droop and alteration of mental status. Nonenhanced brain MRI:No evidence of acute intracranial process and in particular no evidence of acute ischemic stroke as is questioned clinically.There is normal anatomical morphology of brain parenchyma and with normal signal intensity on all MRI sequences. Mild prominence of cortical sulci and the supratentorial ventricular system likely still within normal range for patient's stated age of 69.The signal void of major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are within normal.Unremarkable images through the orbits.Unremarkable images through the paranasal sinuses.Extensive bilateral mastoid air cell opacification and suspected partial opacification of the right middle ear cavity. Recommend correlation with clinical symptomatology and dedicated imaging.
1.Negative nonenhanced brain MRI.2.Extensive bilateral opacification of mastoid air cells and suspected partial opacification of right middle cavity.