42 year old male with acute right sided numbness and acute left neck pain; patient has a  history of seizures and hypertension.

MR Coronal T2-w spin echo and MR FLAIR; MR diffusion

CT Head and T1-w sequences are not available.

MR T2 Flair
1. Evidence of an acute seizure event based on subtle hippocampal edema.
2. There is evidence of an acute high cervical ICA dissection with luminal narrowing in the 50% range, but with persistent antegrade filling.

MR diffusion (DWI)
1. There is evidence of a hyperacute seizure event with positive restriction confined to the left hippocampus.
2. There is no evidence of hyperacute ischemic event in the left arm cortex to suggest an acute ischemic event as a cause of the presenting symptoms of right arm paresis.

MR Susceptibility (SWI) is not available

1. Patient has a history of epilepsy and presents with neck pain and right sided numbness. Symptoms were felt to be related to an acute stroke and a stroke protocol MR was obtained. However, the MR revealed evidence of acute post seizure hippocampal edema with positive water restriction. The changes did not include the uncus or parahippocampal cortex to confirm stroke of the anterior choroidal or P2-PCA arteries. In addition, there is evidence of an acute high cervical ICA dissection with only partial luminal narrowing. The findings are most consistent with relatively strong recent seizure event, which resulted in convulsions, which caused the left high cervical left ICA dissection, which caused the acute neck pain. There was not left cerebral cortical embolic event.