78 years Female (DOB:5/18/1938)Reason: R ICA aneurysm; L sided weakness in April; known aneurysm surveillance for short term stability History: L sided weakness in April; known aneurysm surveillance for short term stabilityPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Additionally there are patchy T2 and FLAIR hyperintense foci in the brainstem and basal ganglia.There is a millimeter-sized focus of susceptibility effect present in the left periventricular white matter adjacent to the trigone of the left lateral ventricle. In isolation this is of unknown clinical significance.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:There is an 8 x 5 mm axial dimension aneurysm present which originates from the distal aspect of the cavernous portion of the right internal carotid artery and extends medially bulging and towards the sella. It is stable and compared to the previous exam.There is 60% stenosis at the right p3 segment of the posterior cerebral artery. This is unchanged since prior exam.Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.The anterior communicating artery is identified. The posterior communicating arteries are small. The vertebral arteries are similar in size.
1.There is an 8 mm aneurysm at the distal cavernous segment of the right internal carotid artery which is stable.2.There is a 60% stenosis of the the right posterior cerebral artery at the p3 segment. This is stable.3.Periventricular and subcortical white matter lesions of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. 