Clinical question: History of Parkinson's, planning for DBS. Signs and symptoms: Preop planning for DBS. Pre-and post enhanced surgical planning MRI:This examination is performed utilizing surgical planning protocol and is not a true diagnostic exam.Within this limitation susceptibility weighted images demonstrate no parenchymal signal abnormality.Post enhanced images demonstrate no detectable abnormal parenchymal or leptomeningeal enhancement.There is a focus of encephalomalacia along the medial aspect of the left mid to posterior temporal lobe and extending into the left occipital with resultant ex vacuo dilatation of the left trigone and occipital horn of left lateral ventricle. In addition a small focus of T2 hyperintensity in the left thalamus is present. Combination of findings is believed to be secondary to a chronic ischemic stroke in the entire distribution of left PCA.Slight prominence of cortical sulci for patient's stated age. Unremarkable exam otherwise.
1.Large chronic ischemic stroke involving the entire distribution of left PCA and with resultant significant extra-axial dilatation of trigone and occipital horn of left lateral ventricle. Mild prominence of cortical sulci for age.2.Essentially unremarkable exam otherwise and without detectable abnormal enhancement.