Cortically based gyriform restricted diffusion within the left parietal lobe (postcentral gyrus), corresponding to the perfusion abnormalities demonstrated on the CT and in keeping with acute infarction. Associated increased T2/FLAIR signal within the affected swollen gyri. An enlarged left superficial cortical vein (the vein of Trolard) shows susceptibility-weighted abnormality representing thrombosis.
Increased FLAIR signal within some parietal and frontal sulci just anterior to the infarct with associated susceptibility weighted artifact, in keeping with a small volume acute sulcal subarachnoid haemorrhage.
No further foci of abnormal restricted diffusion. Otherwise normal signal intensity of the neuroparenchyma. Neuroparenchymal volume is preserved. The ventricular system is within normal limits for age.
IMPRESSION
Acute infarct within the cortex of the left parietal lobe secondary to thrombosis of the vein of Trolard. Small volume of adjacent acute sulcal subarachnoid haemorrhage but no intraparenchymal haemorrhage.