History of ataxia and vertigo, for the last 4 days. Assess for stroke. BRAIN MRI:There is no acute infarct. There is a tiny focus of susceptibility effect in the left frontal centrum semiovale which may represent hemosiderin staining or calcification. There is no associated edema or perceptible abnormality on the STIR sequences. There is no intracranial hemorrhage otherwise.Confluent periventricular and punctate deep and subcortical white-matter T2 FLAIR hyperintensities are present in both cerebral hemispheres. These are nonspecific but most likely reflect mild chronic microvascular ischemia. Focal CSF intensities in the left putamen and the medial aspect of the temporal lobes probably represent perivascular spaces and/or small cysts, which may be a normal variant. There is no space-occupying brain lesion. There is no midline shift or brain herniation. The ventricles and the other CSF-containing spaces are mildly expanded, reflecting mild global brain volume loss. The flow voids of the major intracranial vessels are preserved, reflecting gross patency.Minimal nonspecific opacification of the mastoid air cells. There is a small retention cyst in the right maxillary sinus. In addition, there is mild mucosal thickening in the right maxillary sinus and bilaterally in the frontal and the anterior ethmoid sinuses. These findings are also nonspecific. Orbits are notable for changes of previous bilateral cataract surgery. There is no destructive skull lesion.CRANIAL MRA:There is no flow-limiting stenosis of the major intracranial arteries. Minimal contour irregularity within the intracranial vasculature may represent mild atherosclerotic disease and/or related to technique. There is no definite aneurysm. NECK MRA:Aortic branching pattern is conventional. There is no significant stenosis of the common and cervical internal carotid arteries. There is mild irregularity of the vessel outline at the carotid bulbs, left more than right, which probably reflects atherosclerosis without significant stenosis. The vertebral arteries are also conventional in anatomy and preserved in caliber.
1.There is no acute infarct, intracranial mass, or mass effect. 2.Mild chronic small vessel ischemic changes in the brain. There is a tiny focus of susceptibility in the left frontal lobe compatible with a chronic microhemorrhage and nonspecific. 3.There is no significant stenosis in the intracranial circulation or the extracranial circulation in the neck.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.