 MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are minimal T2/FLAIR hyperintensities scattered in the subcortical frontal white matter which is nonspecific. The brain parenchyma and pituitary gland otherwise appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is complete opacification of the right maxillary sinus which is underdeveloped.MRA Brain: The intracranial internal carotid arteries demonstrate no significant stenosis. The middle and anterior cerebral arteries are also patent. The vertebral arteries, basilar artery, and posterior cerebral arteries also are patent with no significant stenosis. No evidence of aneurysms. The posterior communicating arteries are not well visualized.MRA Neck: There is a common origin of the left common carotid artery and brachiocephalic artery, with a separate origin of the left subclavian artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. However, the mid to distal right V2 segment appears irregular, although evaluation is limited due to surrounding venous structures. Similarly, the course of the proximal right V3 segment appears unusual with difficulty following the vertebral artery at this level, again with evaluation limited due to surrounding venous structures and possible collateral vessels. There is no evidence of definite flow-limiting stenosis or occlusion.
1.No evidence of intracranial abnormality. 2.Incomplete evaluation of the mid to distal cervical right vertebral artery, with evaluation somewhat limited due to surrounding venous contamination, although there is also concern for slight aberrant course of the distal right vertebral artery and possible collaterals. CTA neck recommended for further evaluation, to exclude possibility of previous dissection.3.Unremarkable MRA of the brain.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.