Presentation
Aphasia and headaches.
Patient Data
Left parietal-temporal cortical hypodensity with loss of grey-white matter differentiation
No intra- or extra-axial collection or hemorrhage. No focal abnormality. Grey-white differentiation is preserved elsewhere. Ventricular size, sulcal pattern, and basal cisterns all appear normal. No bony abnormality.
Probable occlusion of a left posterior M3 branch on MIP images (not shown)
Left Inferior lobar thyroid nodule.
Ischemic lesion within left parietal-temporal lobes with a corresponding hyperintense signal on FLAIR images.
Flair hyperintensities within the subcortical and periventricular white matter, in keeping with a chronic cerebral small vessel disease.
Poor opacification of the distal left PCA compared to the right side.
Mild perivascular hemosiderosis/loss of normal flow void in a left M3 branch (low signal on SWI and MRA).
The hypoattenuation and swelling are more marked, but there is no significant mass effect or bleeding.
Case Discussion
The mechanism of vessel obstruction, in this case, is probably due to embolism, since there is no significant cerebral arteriosclerosis.
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