Reason: cavernous aneurysm; vertebral pseudo aneurysm, history of cerebellar stroke; changes? History: transient right visual change, dizziness MRI of the brainNo diffusion weighted abnormalities are appreciated. There is encephalomalacia along the right cerebellar hemisphere.A couple punctate T2 and FLAIR hyperintense lesions are present in the cerebellar hemispheres . There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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 a 2mm aneurysm at the left ICA at the origin of the left anterior choroidal artery which is unchanged since a CTA from 12/18/2008 CTA.There is a 3.5 mm left cavernous carotid aneurysm present directed medially at the level of the posterior bend which is unchanged since a CTA from 12/18/2008 CTA.There is a 1.5mm aneurysm present along the proximal ophthalmic segment of the RICA which is directed inferiorly and laterally which is unchanged since a CTA from 12/18/2008 CTA.There is a small infundibulum at the origin of the left PCOMA.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 right A1 segment is hypoplastic. The posterior communicating arteries are small. The vertebral arteries are asymmetric in size - right larger than left. There is a mild focal dilation of the intracranial LVA distal to the PICA origin. The left PICA and right PICA each have an infundibulum.
1.There is a 2mm aneurysm at the left ICA at the origin of the left anterior choroidal artery which is unchanged since a CTA from 12/18/2008 CTA.2.There is a 3.5 mm left cavernous carotid aneurysm present directed medially at the level of the posterior bend which is unchanged since a CTA from 12/18/2008 CTA.3.There is a 1.5mm aneurysm present along the proximal ophthalmic segment of the RICA which is directed inferiorly and laterally which is unchanged since a CTA from 12/18/2008 CTA.4.There is mild focal dilation of the intracranial LVA which is stable.5.There are infundibulae present at the origins of the left PCOMA and left and right PICA. 6.No evidence for cerebrovascular occlusive disease.7.There is encephalomalacia along the right cerebellar hemisphere.8.Periventricular, subcortical and cerebellar white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 