Temporary aphasia - concern for TIA. Brain MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild diffuse cerebral white matter T2 hyperintensity, particularly in a periventricular distribution. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Brain MRA: There is no evidence of significant steno-occlusive cerebrovascular lesions or aneurysms. There is a fetal left posterior cerebral artery and a hypoplastic left A1 segment, which are anatomic variants.Neck MRA: The proximal portions of the bilateral vertebral arteries are not well-delineated, likely due to artifact, although stenosis cannot be excluded. Otherwise, there is no evidence of significant steno-occlusive lesions.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct. Mild diffuse cerebral white matter T2 hyperintensity, particularly in a periventricular distribution may represent chronic small vessel ischemia.2. No evidence of significant steno-occlusive lesions or aneurysms. 3. The proximal portions of the bilateral vertebral arteries are not well-delineated, likely due to artifact, although stenosis cannot be excluded. Otherwise, no evidence of significant steno-occlusive lesions in the neck arteries. However, a CTA may be useful for further delineation if the status of the vertebral arteries are of clinical concern.