Evaluate hemorrhagic stroke in reported left frontoparietal areaSigns and Symptoms: as above MRI of the brainNo diffusion weighted abnormalities are appreciated.There is a focus of heterogeneous signal present on T2 and FLAIR MRI which is predominantly high signal and associated with local volume loss located in the left centrum semiovale. Adjacent sulci are widened. This suggests this represents a focus of encephalomalacia. There is no associated contrast enhancement.Punctate foci of signal loss identified on susceptibility imaging in the right frontal periventricular white matter and right frontal subcortical white matter.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. 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 no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size. There is fetal origin of the right posterior cerebral artery with a small right P1 segment. The left posterior communicating artery is medium-sized. The right A1 segment is slightly larger than the left A1 segment. The left posterior cerebral artery appears to be larger than the right posterior cerebral artery. The right vertebral artery is much smaller than the left vertebral artery. There is extracranial origin of the right posterior inferior cerebellar artery
1.There is a focus of encephalomalacia present in the left centrum semiovale.2.A couple microhemorrhages in the right frontal lobe in isolation are probably of little clinical significance.3.No evidence for acute cerebral infarction.4.No evidence for cerebrovascular occlusive disease.5.No evidence for intracranial aneurysm.