There is extensive low T1 with corresponding high T2 signal intensity seen corresponding to the distribution of the left PCA territory (with involvement of the grey matter/cortex) including the left MCA/PCA cortical border zone superiorly (parietal lobe) and the left thalamus. Regions of lower T2/FLAIR signal intensity corresponding to loss of signal on the susceptibility sequence obtained is most compatible with foci of microhaemorrhages within the region.
Affected areas demonstrates pronounced gyriform enhancement. Presence of gyriform enhancement in the small region of T2 hyperintensity in the right parietal occipital lobe, as well as a tiny cortical focus in the right superior frontal gyrus adjacent to the precentral sulcus, documents the presence of further smaller regions of subacute ischaemia in the right hemisphere.
Normal MRA. In particular, the left PCA appears patent. Remainder of the brain is unremarkable.
CONCLUSION:
The morphology of the contrast enhancements confirms the diagnosis of subacute infarction. This involves the entire left PCA territory, as well as a moderate region in the posterior left MCA territory, and contralateral hemisphere involvement abutting the right precentral sulcus and the right parieto-occipital lobe. Involvement of at bilateral MCA and PCA vascular territories suggests a central embolic source.