72 years Female (DOB:1/17/1944)Reason: SAH? Prior SAH/aneurysm, now vomiting/presyncope History: vomitingPROVIDER/ATTENDING NAME: NATHAN S TRUEGER NATHAN S TRUEGER 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 degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images without associated DWI abnormalities.No abnormal mass lesions are appreciated intracranially. 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 demonstrate a minor mucous retention cyst in the right maxillary sinus. 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 redemonstration of recanalization at the aneurysm base apparently covered by coils (helmet effect) measuring 1.2 mm.There is asymmetry in the A1 segments right larger than left. The anterior communicating artery is identified and is medium size. The posterior communicating arteries are intact. The vertebral arteries are similar in size.
1.The examination is stable compared to the 6/2014 exam. There is redemonstration of early recanalization into the aneurysm coils at the base of the ACOMA aneurysm by approximately a millimeter.2.Redemonstration and no change of periventricular and subcortical white matter changes of a mild degree are nonspecific. They are most likely vascular related.