Female, 64 years old, with new onset headache. Evaluate for metastasis, bladder cancer primary. MRI brain:No evidence of restricted diffusion, edema or mass effect is seen. No pathologic intracranial enhancement is observed. There are numerous scattered small foci of T2 hyperintensity within the cerebral hemispheres which are nonspecific. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. Ventricular size and morphology are within normal limits.MRA brain:No evidence of significant vascular stenosis or occlusion is seen. No aneurysm or vascular malformation is suspected.MRA neck:Conventional aortic branching is seen. The origins of the great vessels are patent. Moderate atherosclerotic disease is present at the carotid bifurcations and proximal ICAs but without significance by NASCET criteria. The vertebral arteries are free of significant vascular stenosis.
1.No evidence of intracranial metastatic disease is seen. Scattered small foci of signal abnormality are favored to represent chronic microvascular ischemia.2.No significant vascular abnormalities are detected intracranially.3.Atherosclerotic disease is seen at the carotid bifurcations and proximal ICAs. However, no areas of critical stenosis are suspected.