Generalized muscle weakness and left facial droop.. There is no evidence of acute infarct. There is interval evolution of the previously demonstrated infarcts in the left cerebral hemisphere watershed area, with associated encephalomalacia, minimal areas of susceptibility effect, and mild ex vacuo dilatation of the left lateral ventricle. Beyond this, there are a few scattered foci of T2 hyperintensity in the cerebral white matter bilaterally, consistent with mild small vessel ischemic disease. There is loss of flow void of the left internal carotid artery within the carotid canal. There is no mass effect, midline shift, or acute intracranial hemorrhage. The paranasal sinuses and mastoid air cells are unremarkable except for secretions and atelectasis of the left maxillary sinus and mild mucosal thickening in the sphenoid sinus.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct.2. Interval evolution of the previously demonstrated watershed zone infarct in the left cerebral hemisphere.2. Redemonstration of chronic left internal carotid artery occlusion.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.