51 years Male (DOB:3/23/1965)Reason: left facial numbness History: left facial numbnessPROVIDER/ATTENDING NAME: NAVNEET CHEEMA MAHESH PADMANABAN MRI of the brainNo diffusion weighted abnormalities are appreciated.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The CSF spaces are appropriate for the patient's stated age with no midline shift. 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 are clear. 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 no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. The left A1 segment is larger than the right A1 segment. There is fetal origin of the posterior cerebral arteries bilaterally associated with hypoplastic P1 segments The left vertebral artery functionally appears to and in the left posterior inferior cerebellar artery.MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries, however, the origins of the vertebral arteries are not imaged adequately for evaluation.. The left common carotid artery originates from the innominate artery.
1.There is no evidence for acute ischemic cerebral infarction.2.There is no evidence for intracranial or extracranial cerebrovascular occlusive disease. However, the origins of the vertebral arteries are not imaged adequately for evaluation.3.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 