Neuro_CTA_Head/Neck: 87 F with recent L MCA stroke s/p thrombectomy, with new word finding difficulty.
1. Small ovoid hypodense lesion in the left parietal subcortical white matter which demonstrates rim enhancement postcontrast, with diminished CBV/CBF and markedly delayed T-Max. While this may subacute infarct with rim enhancement given perfusion findings and recent history of stroke with neurointervention, the relative cortical sparing, rounded appearance, mild surrounding edema are atypical. Other rim-enhancing lesions such as evolving hematoma, abscess, or mass could give this appearance. Further evaluation with contrast-enhanced MRI recommended.2. No flow-limiting stenosis or occlusion in the intracranial circulation. Small conical outpouching at the basilar terminus eccentric to the left likely represents infundibular origin to hypoplastic left P1 rather than tiny aneurysm.
3. Severe stenosis of the right vertebral artery origin. Moderate narrowing of the bilateral carotid bulbs.
(Subacute hematoma)
Accession: CL0366
Study description: CT HEAD PERFUSION WITH CONTRAST
