Parkinson's disease [G20], Reason for Study: ^Reason: parkinsons History: tremor There is very prominent enhancing tubular structure on the posterior aspect of the distal basilar artery (series 401, image 80) and located at the interpeduncular fossa. Superior aspect of this structure is following the right PCA and it appears to be connected to the left posterior cavernous sinus. Possibility of this structure is prominent interpeduncular vein.However, since the vein is too prominent than usual on MRI, the possibility of arteriovenous shunting or duplicated right PCA cannot be completely excluded. For further imaging evaluation, CTA and CTV can be considered. However, if those imaging studies are not conclusive, diagnostic catheter angiography can be the next resort if clinically indicated.Scattered T2 high signal intensity lesions on periventricular white matter and centrum semiovale are seen which are nonspecific.There is no evidence of acute hemorrhagic lesion on the scan.There is no evidence of abnormal enhancement on the scan. The ventricles, sulci and cisterns are symmetric and unremarkable. The paranasal sinuses and mastoid air cells are clear.
1. Non specific T2 high signal intensity lesions on periventricular white matter.2. No abnormal enhancing parenchymal lesion.3. Likely vascular structure seen on the posterior aspect of the distal basilar artery. Differential diagnosis include prominent interpeduncular vein, possible arteriovenous shunt or duplicated right PCA.CTA and CTV of head can be considered for further imaging investigation if clinically indicated.