Reason: vertigo with vertical nystagmus, headache; eval brainstem ischemia History: s/p nephrectomy, s/p stem cell tx for multiple myeloma. MRI of the brainNo diffusion weighted abnormalities are appreciated. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. There is mild mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries. There is no evidence for intracranial aneurysm or cerebrovascular occlusion. There is no evidence of abnormality within the anterior posterior arterial circulation. The vertebrobasilar system appears normal, with patent vertebral arteries, PICAs, AICAs, SCAs, and PCAs bilaterally.
Normal MRA and MRI of the brain. No pathologic findings to explain patient's symptoms. 