Clinical question: 61-year-old African-American female with PVD, clots, no not withdrawing to pain left upper extremity. Signs and symptoms: Left upper extremity weakness. Nonenhanced brain MRI:There is no evidence of an acute intracranial process and in particular no evidence of acute ischemic stroke detected.There are patchy foci of flair hyperintensity in the subcortical and minimally ventricular white matter of cerebral hemispheres which are nonspecific however in proper clinical setting could represent mild chronic small vessel ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination otherwise.The signal void of major intracranial arterial branches are identified.Calvarium is intact. There is a focus of subgaleal hemorrhage and in right posterior temporal region measuring maximum of 1.8-mm in thickness. Unremarkable images through the orbits, paranasal sinuses. Extensive opacification of bilateral mastoid air cells.
1.No acute ischemic stroke.2.Findings suggestive of mild age indeterminate small vessel ischemic disease.3.Tiny focus of subgaleal hemorrhage in the left posterior temporal.4.Extensive bilateral mastoid air cell opacification.