Hereditary hemorrhagic telangiectasia [I78.0], Reason for Study: ^Reason: eval for AVM's History: HHT, nosebleeds Brain MRINo evidence of acute ischemic or hemorrhagic lesion on the scan.Multifocal scattered high signal intensity lesions on bilateral white matters on FLAIR imaging indicate nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA:3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.No evidence of intracranial aneurysm. No evidence of intracranial arterial significant luminal stenosis.
1. Minimal nonspecific small vessel ischemic disease. Otherwise no evidence of acute ischemic or hemorrhagic lesion.2. Normal brain MRA. Comment: Further imaging investigation with Gad enhanced MRI can be considered if small brain AVM is suspected. 