48 years Female (DOB:3/31/1968)Reason: s/p Left sup hypophyseal artery aneurysm coiling History: follow upPROVIDER/ATTENDING NAME: JACQUELINE D SMART JACQUELINE D SMART MRI of the brainNo diffusion weighted abnormalities are appreciated.There is redemonstration of a small focus of encephalomalacia along the posterior aspect of the left occipital lobeThere are several 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 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 demonstrate mucous retention cysts in the maxillary sinuses which were also present on prior exams. The visualized portions of the orbits are intact.MRA brain:There is redemonstration of status post embolic coil occlusion of a left superior hypophyseal aneurysm associated with a small neck remnant measuring 1.5 mm height and 2.5 mm width. This has not changed substantially since the 4/15/2015 exam.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. The posterior communicating arteries are identified. The right posterior communicating artery is medium-sized whereas the left posterior communicating artery is very small. The vertebral arteries are similar in size.
1.Since the prior exam the patient's previously treated left superior hypophyseal aneurysm remains stable with a small neck remnant.2.Several periventricular and subcortical punctate lesions are likely of little clinical significance given their small number in the frequency with which these are seen at these numbers at this age.. 3.A small focus of encephalomalacia is present in the left occipital lobe and is unchanged since previous exams.