Jill K. Billions, MD

A 53-year-old woman presents to the emergency department (ED) with altered consciousness. Seen in

 is the brain CT scan obtained at ED presentation. The diffusion weighted imaging (DWI) sequence obtained on MRI 

 was obtained 12 hours following the CT scan. 

 is an apparent diffusion coefficient (ADC) mapping sequence on MRI, also obtained 12 hours following the CT.

After studying these 3 images, what is your diagnosis?

A. Right parietal acute to early subacute infarct and left frontoparietal chronic infarct.

B. Right parietal chronic infarct and left frontoparietal acute to early subacute infarct.

C. Right parietal cerebral abscess and left frontoparietal chronic infarct.

D. Right parietal intraparenchymal cerebral hemorrhage and left frontoparietal acute to early subacute infarct.

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Take a look at these 3 images and see if you can pinpoint the cause of altered consciousness in this woman.