88 years Female (DOB:12/6/1927)Reason: stroke History: Left MCA syndromePROVIDER/ATTENDING NAME: KEEGAN CHECKETT AGNIESZKA ANNA ARDELT MRI of the brainThere is a focus of diffusion restriction involving the right SCA territory measuring 40x28mm axial dimensions. There is a focus of diffusion restriction involving the left thalamus measuring 18x12mm axial dimensions. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is occlusion of a short segment of the basilar artery distal to AICA origin which does not involve the top of the basilar artery. The right PCOMA is medium sized and supplies the top of the basilar artery. There is occlusion of the right SCA and the left PCA. There is narrowing of the distal right RVA at the VB junction.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.Acute infarctions involving the right SCA territory and the left thalamus. The brainstem is not involved.2.Occlusion of the distal basilar artery, the right SCA and the left PCA. The top of the basilar artery is supplied by the right PCOMA.3. Findings were discussed with Dr Ardelt at the time of the exam.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.