82 years Male (DOB:10/27/1933)Reason: now acute ischemia? H/O of prior L MCA and seizures History: new onset Left sided weakness, s/p TpaPROVIDER/ATTENDING NAME: CHRISTOPHER L KRAMER CHRISTOPHER L KRAMER There is diffusion restriction present along the right pre and postcentral gyri as well as the inferior aspect of the right paracentral lobule and adjacent cingulate gyrus with some scattered punctate foci of diffusion restriction in the right superior and middle frontal gyri as well as the medial aspect of the right cingulate gyrus anteriorly.. There is susceptibility effect present along the inferior aspect of the right paracentral lobule and adjacent right cingulate gyrus.There is a focus of encephalomalacia present in the left frontal lobe involving the left superior, middle and inferior frontal gyri associated with ex vacuo effect.The left internal carotid artery flow-void is absent. The left posterior communicating artery appears large, however, the left P1 segment appears small. Normal vascular flow voids are present in the distal right carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is an acute or subacute infarction involving the right pre and postcentral gyri as well as portions of the right paracentral lobule and right cingulate gyrus with surrounding punctate lesions implying that there has been a thromboembolic event involving parts of the right anterior and middle cerebral artery territories. Please correlate with clinical history2.Findings suggest occlusion of the left internal carotid artery3.There is encephalomalacia present involving the left frontal lobe4.Examination is degraded due to patient motion artifact which will obscure more subtle abnormalities