Reason: evaluate for lupus cerebritis or other changes related to lupus History: new diagnosis of lupus, retinopathy on exam, hypertension. MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. 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:There is narrowing of the proximal right m1 segment and distal right ICA.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.The anterior communicating artery is identified and is medium size. The posterior communicating arteries are identified and are small . The vertebral arteries are asymmetric - left smaller than right.MRV brain:The dural venous sinuses are patent. Straight sinus, internal cerebral veins and basal veins are identified and appear patent.
1.Findings suggest significant narrowing at the origin of the right MCA and distal right ICA. This can be confirmed using a CTA.2.No evidence for intracranial aneurysm.3.MR venogram of the brain is within normal limits4.No evidence for intracranial mass lesion.