Male, 71 years old, with weakness. Possible TIA. MRI brain:No convincing restricted diffusion is seen. Numerous scattered periventricular and subcortical foci of T2 hyperintensity are evident within the cerebral hemispheres and brainstem. No evidence of significant edema or mass effect is seen. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricles are normal in size and morphology.MRA brain:No high-grade intracranial stenosis or vascular occlusion is seen. There is mild irregularity of the cavernous ICAs. The ACOM artery is small and unremarkable. Prominent bilateral PCOM arteries are seen. No aneurysm or vascular malformation is suspected.MRA neck:Conventional aortic branching is seen. The origins of the great vessels are not well seen due to technical artifact. The carotid vessels of the neck are free of significant vascular stenosis by NASCET criteria. The origin of the right vertebral artery is not well seen. Otherwise, the vertebral arteries are free of significant vascular stenosis or occlusion.
1.No acute ischemia or other definite acute intracranial abnormality is seen. Findings compatible with chronic microvascular ischemic disease are evident.2.No significant vascular stenosis or occlusion is detected in the head or neck.