68-year-old female with SLE, HTN, CAD with episodes of hallucination with facial weakness and limited upgaze. A moderate or vasculitis or vascular pathology. CT of brain without infusion.No evidence of hemorrhage, cortical stroke, mass effect, edema or midline shift is detected. Previously reported small muscle disease on MRI examination is not visible on this study.The bony density of calvarium, pneumatization of paranasal sinuses and mastoid air cells are also unremarkable.CTA of intracranial circulation.CTA of the carotid system demonstrates patent bilateral intracranial portions of the carotid arteries with no abnormality in particular no evidence of vasculitis. There is also good visualization of bilateral anterior and middle cerebral arteries and all of their branches. Within the limitation of CTA no evidence of vasculitis of the left middle or anterior cerebral arteries or their branches is detected.CTA of vertebral basilar system demonstrates patent bilateral intracranial components of the vertebral arteries with no pathology. There is good visualization of bilateral PICAs. The basilar artery is also well visualized and demonstrates no pathology. There is normal visualization of bilateral posterior cerebral arteries and superior cerebellar arteries with no evidence of pathology in particular no evidence of vasculitis.Within the limitation of CTA no evidence of vasculitis of the branches of the posterior cerebral arteries or superior cerebellar arteries is detected.
Unremarkable CTA of intracranial circulation.Within the limitation of CTA for detection of small vessel vasculitis this is study is unremarkable. 