Reason: CTh with subacute stroke History: 89 year old male with PMH significant for CAD, CHF. HTN, and previous throat cancer who presents with 2-3 day history of lethargy and altered mental status and had a mechanical fall on the day of admission. Due to the patient's inability to cooperate fast sequences were used There is diffusion restriction present involving the right caudate nucleus, the right anterior limb of the internal capsule and the right putamen. This measures 30 x 34 mm axial dimensions. There is associated T2 and flair MRI signal change. Punctate foci of signal loss on susceptibility imaging are present within the right tutamen and along the right anterior limb of the internal capsule.A focus of signal hyperintensity on T2 and flair MRI imaging located along the left thalamus is present. There is associated punctate signal hypointensity on SWI.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 partially opacified along the ethmoid air cells. The visualized portions of the mastoid air cells demonstrate minor opacities. The visualized portions of the orbits are intact.
1.There is a subacute infarction involving right basal ganglia and anterior limb of internal capsule associated with petechial blood products.2.Older left thalamic lacunar infarction.3.Exam was performed using fast imaging techniques. Subtle abnormalities may be less obvious as a result.