 MRI Brain:The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. Moderate periventricular and subcortical T2/FLAIR hyperintense foci, nonspecific and probably reflecting chronic small vessel ischemic disease. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Patchy right mastoid air cell opacification noted.MRA neck:Phase contrast technique is limited in evaluation of tortuous segments of the vasculature. There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. There is mild atherosclerosis of the carotid bifurcations, left greater than right. The carotid arteries are normal in course without evidence of significant steno-occlusive lesion. Both vertebral artery origins are patent. The vertebral arteries are co-dominant. There is no evidence of stenosis or occlusion.
1.Chronic small vessel ischemic disease. No evidence of acute ischemia.2.Within the limitations of a noncontrast MRA, there is no gross vascular compromise in the major neck arteries.