Other visual disturbances [H53.8], Reason for Study: ^Reason: vasculitis of internal carotid History: concern for vasculitis Motion artifacts significantly degraded image quality.There is no evidence of acute ischemic or hemorrhagic lesion.The left distal ICA lumen appears to be significantly (more than 50%) narrowed in long segment especially from the opthalmic segment to the ICA bifurcation.Vascular wall imaging, even with significant motion artifacts so precise evaluation is not possible, shows thickening of left ICA distal petrous segment with diffuse wall enhancement (series 1601, image 1-4, series 2301, image 1-4 and series 2001, image 1-4). Wall thickening and enhancement of the left ICA's cavernous sinus segment is not possible due to diffuse cavernous sinus enhancement. The supraclinoid segment of the left ICA does not show any evidence of wall thickening or wall enhancement.In general, active vasculitis can show multi layer wall thickening indicating active inflammation and wall edema. Therefore, diffuse homogeneous type of wall enhancement which is shown on the left ICA is likely representing fibrosis of arterial wall. In addition, there is no evidence of intra dural arterial wall enhancement which may indicate active intracranial arteritis.There is again left basal ganglia and external capsule encephalomalacia, unchanged.No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci and cisterns are unremarkable. There is no intracranial abnormal brain parenchymal enhancement.Inclusion cyst on the left temporal scalp is again seen, unchanged.The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of active intracranial arteritis. Diffuse wall thickening of enhancement seen on extra dural segment of the left ICA more likely represent fibrotic changes of arterial wall.2. Unchanged left basal ganglia and external capsule encephalomalacia.3. Unchanged left temporal scalp inclusion cyst.4. No evidence of acute ischemic or hemorrhagic lesion. 