6 years, Female, nose bleeds. Hereditary hemorrhagic telangiectasia. Brain MRI: Brain parenchyma appears within normal limits. There is no parenchymal signal abnormality. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Post gadolinium sequences, series 1501 and 1701, demonstrate no abnormal parenchymal or meningeal enhancement.Sella and orbits are grossly within normal limits. There is diffuse opacification of the left maxillary and left sphenoid sinuses. There is mild opacification involving the paranasal sinuses on the right. There is also diffuse opacification of the left middle ear cavity and left mastoid air cells. Bone marrow signal and extracranial soft tissues are otherwise grossly unremarkable. There is mild asymmetric prominence of the left cervical lymph nodes, which is nonspecific.Brain MRA: 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 or vascular malformations.
1. Brain MRI and MRA appear within normal limits. Specifically, there is no evidence of a vascular malformation.2. Diffuse opacification of the left-sided paranasal sinuses as well as the left middle ear cavity and mastoid air cells, which can be correlated with clinical findings.