Right side weakness There is no evidence of acute ischemic or hemorrhagic lesion on this scan.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. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate significant (more than 50%) of luminal stenosis and irregularity on the right MCA M1 segment. The left MCA shows subtle luminal irregularity but did not show any significant luminal stenosis. Bilateral PCAs are fetal origin.Vertebrobasilar system shows relatively smaller diameter and shows tortuosity, however, do not show any significant luminal narrowing. There is no evidence of intracranial arterial aneurysm.3D 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 origin appear to be normal but the left vertebral artery appears to be small in diameter. The left vertebral artery completes as left PICA. No aneurysm was seen.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Significant (more than 50%) stenosis of the right MCA M1 segment with irregularity as well as left MCA luminal irregularity indicate atherosclerotic changes.3. Bilateral fetal PCAs with relatively small vertebrobasilar system, especially left vertebral artery is hypoplastic.4. Bilateral carotid bifurcations appear to be normal. 