70 years Female (DOB:1/10/1946)Reason: eval cva History: L hand weaknessPROVIDER/ATTENDING NAME: DANIEL W ROBINSON MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Patchy T2 and FLAIR hyperintense lesions are present in the pons and lower midbrain..No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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: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.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. There is fetal origin of the left posterior cerebral artery. The right posterior communicating artery is very large. There is an infundibulum at the origin of the posterior communicating arteries bilaterally. The left vertebral artery is larger than the right vertebral artery. The right vertebral artery predominantly supplies the right posterior inferior cerebellar artery and is hypoplastic distal to that.
1.Periventricular and subcortical white matter lesions of a mild to moderate degree as well as patchy lesions in the brainstem are nonspecific. At this age they are most likely vascular related.2.No evidence for acute ischemic cerebral infarction.3.No evidence for intracranial cerebrovascular occlusive disease.