Male, 60 years old, with known stroke and intracranial hemorrhage. Since the prior MRI examination, the intensity of diffusion restriction along the bilateral cerebral watershed zones, right side more than left, has diminished compatible with expected evolution. However, one area of restricted diffusion within the paramedian right parietal lobe is new compared to prior.Faint susceptibility effect and T1 hyperintensity is seen along the affected gyri compatible with trace or petechial blood product. No large or discrete parenchymal hematoma is seen. No significant generalized mass effect is detected.A colloid cyst at the foramen of Monro is unchanged. Asymmetric dilatation of the right lateral ventricle is also unchanged. Ventricular size and caliber are stable relative to the prior examination. T2 hyperintensity in the basal ganglia is again seen which may reflect chronic lacunar ischemic disease or prominent perivascular spaces.
1.Since the prior MRI, the intensity of diffusion restriction in the areas of watershed infarction has generally diminished consistent with expected evolution. However, one small area of new gyriform restricted diffusion is seen along the paramedian right parietal lobe which may reflect some expansion of ischemic disease.2.Corresponding to the suspected blood product on CT, there is vague susceptibility effect and T1 hyperintensity along the gyri of the watershed infarctions. As before, this likely represents a small quantity of petechial blood product with mineralization a less likely consideration given the relatively quick time course of development. 3.No change in the appearance of a colloid cyst at the roof the third ventricle or asymmetric dilatation of the right lateral ventricle.