Rehabilitation notes

Large part of the penumbra seen on the CT perfusion images underwent infarction as seen on the FLAIR images taken two weeks later.

The main lesion involves the left inferior parietal lobe including the supramarginal and angular gyri, and the posterior part of the superior temporal gyrus. The lesion affects both the grey matter and its underlying white matter. The functional networks most likely to be affected are the Central Executive Network 1 and the Default Mode Network 2

Brain health is also compromised with: 1) a previously undetected right frontal lesion, 2) white matter disease seen on the FLAIR images, and 3) multiple small old lesions of the cerebellum and pons seen on the T2 posterior fossa images. 

Motor function and neglect recovered well, whilst the recovery of dysphasia was limited. Recovery was impeded by additional cognitive issues (impaired processing speed, planning and organization, basic mathematical skills, immediate visual memory and fluctuating attention and concentration). The cognitive issues could be attributed to both the affected networks and reduced brain health.