Bilateral hyperacute middle cerebral artery territory infarcts

Leftmiddle cerebral (M1 segment) andintracranial internal carotid arteries appears appear hyperdense, likely representrepresenting thrombus, with subtle loss of grey-white matter differentiation in left insula.

-------SuggestiveSuggestive of left MCA territory hyperacute infarct.

Extensive bilateral diffusion restriction in bilateral cerebral hemispheres, mildly extending into the basal ganglia in the territory of the middle cerebral arteries. There is sparing of the thalamus. Few small patchy areas of T2W/FLAIR hyperintensity in the bilateral cerebral hemisphere. A few small patchy areas of blooming on SWI with the corresponding hyperintensity on phase images, likely represent early hemorrhagic transformation. On T2W images, there is a loss of flow void in the left ICA and MCA, which likely represents a thrombus.

-----SuggestiveSuggestive of Bilateralbilateral MCA territory hyperacute infarcts with early hemorrhagic transformation.

There is non opacification-opacification of bilateral middle cerebral arteries and left distal internal carotid artery, consistent with thrombosis.

There is also nonvisualizationnon-visualisation of the left external carotid artery, likely due to partially calcified atherosclerotic plaque causing near-complete luminal narrowing just after its origin from the common carotid artery.