Headache [R51], Reason for Study: ^Reason: concern for acute ischemic stroke 2/2 to vertebral dissection History: neck pain, ataxia Gradient-echo technique sequences of head was not performed and fat saturated the sequences of neck is nondiagnostic due to poor image quality, thus non-diagnostic. Brain MRI:There is no evidence of acute ischemic stroke.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Neck MRA3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The right vertebral artery is hypoplastic and the left one is dominant.There is no evidence of occlusion, stenosis or any direct evidence of dissection of the vertebrobasilar system.The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. No evidence of acute ischemic lesion in the brain.2. No direct evidence of vertebrobasilar dissection. Hypoplastic right vertebral artery and dominant left vertebral artery are normal variation. 3. Non diagnostic fat saturated MRI from skull base to neck and gradient echo sequence of the brain were not obtained, thus can be repeated without charge if clinically indicated. 