 MRI Brain:Full evaluation is limited by extensive motion degradation. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild periventricular and subcortical white matter T2/FLAIR hyperintensity, which is nonspecific but likely related to chronic small vessel ischemic disease. There is moderate global volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact.Similar to the recent prior head CT, there is near complete opacification of the right maxillary sinus with opacities involving the right greater than left ethmoid air cells and small amount of fluid in the bilateral sphenoid sinuses. T2 hyperintensity and mild swelling seen in the subcutaneous fat of the right posterior neck, may represent dependent edema or related to recent trauma. A left parietal scalp fat intensity lesion likely represents a lipoma. An old burr hole is seen along the left parietal bone.MRA Brain: Full evaluation is limited by extensive motion degradation. The intracranial internal carotid arteries demonstrate no significant stenosis. The middle and anterior cerebral arteries are also patent. The anterior communicating artery is not definitely visible. The majority of the basilar artery is not visualized extending cranially from the vertebrobasilar junction, measuring approximately 1 cm in length. The bilateral PCAs are visualized and supplied by posterior communicating arteries with small P1 segments bilaterally. The upper aspect of the short segment of visible basilar artery as well as the small bilateral SCAs likely have retrograde flow-related enhancement, from the anterior circulation. The AICAs are not definitely seen. The vertebral arteries are patent with no significant stenosis. The bilateral PICA arteries are visualized. No evidence of aneurysms.
1.Full evaluation is limited by extensive motion degradation. No evidence of acute infarct. 2.Mild chronic likely small vessel ischemic disease and moderate diffuse cerebral atrophy.3.The majority of the basilar artery is not visualized, with likely retrograde filling of the distal portion. This is favored to be chronically occluded, less likely developmental. The AICAs are not definitely visualized.4.Diffuse paranasal sinus findings. Please correlate clinically for possible acute sinusitis.