Cerebral infarction, unspecified [I63.9], Reason for Study: ^Reason: cva History: cva Brain MRI:Multiple restricted diffusion lesions on the right MCA territory indicating acute/subacute ischemic infarctions involving right frontal, and parietal lobes. In addition, there is restricted diffusion lesion on the junction of right posterior temporal lobe and occipital lobe indicating possible watershed infarction.The right frontal operculum lesions show susceptibility artifacts on Gradient Echo images, thus indicating hemorrhagic conversion.The ventricles, sulci and cisterns are symmetric and unremarkable.The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA:3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate about 2.6mm length filling defect on the proximal right MCA M2 segment inferior division indicating remained intravascular thrombus. This finding is supporting the brain MRI finding of right temporo-occipital watershed type of ischemic infarction.Otherwise bilateral distal ICA, left MCA, bilateral ACAs and vertebrobasilar system appear to be normal without showing evidence of significant (more than 50%) luminal stenosis or intracranial arterial aneurysm.
1. Acute/Subacute ischemic infarctions on the right MCA territory with evidence of hemorrhagic conversion on the right frontal operculum.2. Acute/subacute ischemic infarction on the right temporal lobe-occipital lobe water shed area with MRA evidence of remained intra vascular filling defect in the proximal right MCA M2 segment proximal division. 