Clinical question: Stroke. Signs and symptoms: Aphasia. Nonenhanced brain MRI:Examination demonstrates a focus of cortical restricted diffusion in the right postcentral gyrus without evidence of hemorrhage and with subtle effacement of adjacent cortical sulci consistent with an acute nonhemorrhagic ischemic stroke.There is a large chronic left MCA territory ischemic stroke involving the left frontal and left basal ganglia with resultant ex vacuo dilatation of the left lateral ventricle.Minimal chronic small vessel ischemic stroke is also noted. Unremarkable images through posterior fossa.The signal void of major intracranial arterial branches are identified.Unremarkable calvarium, soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells.
1.Small acute cortical ischemic stroke in the right post central gyrus without evidence of hemorrhage.2.Large chronic left MCA territory stroke with resultant ex vacuo dilatation of left lateral ventricle.3.Unremarkable exam otherwise.