Clinical question: Mass? Signs and symptoms: Right basal ganglia hypodensities seen on CT. Nonenhanced brain MRI:Examination demonstrates a large focus of restricted diffusion in the right basal ganglia consistent with an acute ischemic stroke. The finding measures at least 12 x 22 mm in transaxial dimensions and corresponds to the region of low-attenuation on prior head CT. There is evidence of susceptibility signal changes within the acute stroke consistent with hemorrhagic changes. This finding results in subtle mass effect on the right frontal horn of lateral ventricle.Additionally examination demonstrate mild to moderate degree of chronic nonhemorrhagic small vessel ischemic strokes primarily in the periventricular and to a lesser degree subcortical white matter of bilateral cerebral hemispheres. Unremarkable cerebral cortex, cortical sulci and CSF spaces.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells.
1.Acute hemorrhagic right basal ganglia ischemic stroke.2.Chronic nonhemorrhagic small vessel ischemic strokes of mild to moderate degree.