Dizziness and giddiness [780.4], Reason for Study: ^Reason: eval for post circulation stenosis, syndrome History: eval for post circulation stenosis, syndrome No evidence of acute ischemic or hemorrhagic lesion on this scan.Minimal to mild diffuse brain atrophy which is age appropriate with minimal patchy high signal intensities on periventricular white matter indicating nonspecific small vessel ischemic disease.The ventricular system appear to be slightly prominent but does not show any evidence of periventricular edema or evidence of occlusion of the CSF pathway. In particular, frontal and temporal horn prominency are proportional, no evidence of upward bowing of corpus callosum and approximate callosal angle appears to be normal.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 tortuosity of the intracranial vessels, however, there is no evidence of intracranial arterial luminal stenosis or narrowing. There is no intracranial arterial aneurysm. The right PCA is fetal origin.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate tortuous arterial system however, normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. 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 or hemorrhagic lesion.2. No evidence of intracranial or extracranial arterial luminal stenosis or irregularity. No intracranial arterial aneurysm.3. Slightly prominent ventricular system without evidence of CSF flow stenosis or occlusion.