72-year-old with history of lung and pancreatic cancer found down at home. Multiple areas of ischemic infarcts noted on recent noncontrast MRI. MRI brain:No foci of abnormal enhancement in the brain. Stable appearance of the very small subdural hematoma overlying the right parietal lobe. Ventricles are normal in size and configuration. No evidence of mass effect, midline shift, or herniation. MRI cervical spine:No abnormal enhancement in the vertebral bodies, epidural space, or cervical spinal cord. Multilevel spondylitic changes are seen which were better evaluated on the noncontrast MRI performed on the same day; see separate report for further details. There is asymmetrically enhancing soft tissue at the right lung apex which may reflect posttreatment change and better assessed with chest CT.MRA brain:Atherosclerotic irregularity of the cavernous internal carotid arteries without significant stenosis. There is an intact circle of Willis. Partial fetal morphology of the right posterior cerebral artery. Left dominant vertebrobasilar system with narrowing and irregularity of the distal extracranial right vertebral artery. No significant intracranial aneurysm. No high-grade steno-occlusive disease in the anterior circulation.MRA neck:The carotid artery origins are widely patent. There is mild atherosclerotic irregularity of the right carotid bulb without significant associated stenosis. There is mild narrowing of the left internal carotid artery beginning at the bulb and extending to the more cranial cervical segment. The right vertebral artery is narrowed at its origin with improved caliber in its mid cervical segment. The left vertebral artery is normal in caliber and contour throughout.
1. Postcontrast images of the brain show no evidence of intracranial metastatic disease. Please refer to separate brain MRI report for additional findings including small infarcts and trace right parietal subdural hematoma.2. Postcontrast images of the cervical spine show no abnormal enhancement in the vertebral bodies, epidural space, cervical spinal cord. Please refer to separate noncontrast cervical spine MRI report for details of multilevel degenerative changes.3. Mild multifocal irregularity involving the nondominant right vertebral and left proximal cervical internal carotid artery likely related to atherosclerotic disease. No high-grade stenosis in the intracranial or extra cranial circulation the neck.