Findings:
Correlating to the CT study an area of diffusion restriction is seen involving the right-sided head of the caudate, anterior putamen and anterior limb of the internal capsule with increased signal intensity on the FLAIR/T2 sequences. Associated mild mass effect with effacement of the right frontal horn. No haemorrhagic changes on the SWI-sequence.
Mild, background small vessel ischaemic disease. Subcortical FLAIR/T2 hyperintensity is noted in the right frontal operculum, likely in keeping with an old post embolic areas of encephalomalacia. The brain parenchyma is otherwise unremarkable.
Partially empty sella is noted.
On the arterial TOF angiography loss of flow signal is seen in the distal M1 segment on the right side. The imaged intracranial circulation is otherwise unremarkable without evidence of any aneurysm. Fetal origin of the right posterior cerebral artery is seen.
The orbits, paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Subacute lacunar infarction of right recurrent Heubner artery territory. No haemorrhagic transformation.
Known, severe stenosis at the right distal M1 segment.