Male, 59 years old, with left hemianopsia and neglect, right MCA M2 occlusion, suspect subacute right cerebellar stroke. Restricted diffusion is seen within the right MCA territory involving the right corona radiata, insula, and a small portion of the right temporal lobe. Restricted diffusion is also seen within the inferior right cerebellar hemisphere in the distribution of the right PICA. There are punctate foci also seen in the right aspect of the medulla. No restricted diffusion is present on the left side of the brain.No evidence of significant parenchymal hemorrhage is seen. The diffusion restricted tissues show corresponding T2 hyperintensity and mild local mass effect. The fourth ventricle is consequently mildly effaced. No significant generalized mass effect or brain herniation is seen. The ventricles are otherwise normal in size and morphology.
Acute infarction is seen in the distribution of the right MCA involving part of the corona radiata, insula and a small part of the temporal lobe. Acute infarction is also demonstrated in the right PICA territory involving the inferior aspect of the cerebellum with punctate foci also seen in the medulla.