 This exam is degraded by motion artifact. There are postoperative findings related to recent left temporal craniotomy and left pial synangiosis procedure. There are multiple foci of susceptibility effect along the left cerebral convexity and a grossly unchanged left-sided extra-axial fluid collection that measures up to 6 mm in thickness. There is a small focus of diffusion restriction involving the anterior left frontal cortex and subcortical white matter. There is a large chronic left hemispheric MCA distribution infarction with extensive encephalomalacia, gliosis, and areas of cortical T1 hyperintensity compatible with laminar necrosis. There are smaller chronic infarcts within the right basal ganglia and centrum semiovale as well as the right occipital lobe. There are a few scattered additional punctate foci of T2 hyperintensity throughout the supratentorial white matter that are most compatible with chronic small vessel ischemic disease. 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.
1.Small acute infarct involving the anterior left frontal cortex and subcortical white matter.2.Postoperative findings related to recent left pial synangiosis procedure with unchanged extra-axial fluid along the left cerebral convexity.3.Unchanged large left hemispheric chronic infarction as well as smaller right basal ganglia/centrum semiovale and right occipital lobe infarcts.