33 years Female (DOB:7/23/1982)Reason: Concern for new vasospasm History: no neuro deficits at this timePROVIDER/ATTENDING NAME: FERNANDO D GOLDENBERG FERNANDO D GOLDENBERG MRI of the brainNo diffusion weighted abnormalities are appreciated.The patient is status post posterior fossa craniotomy for right posterior inferior cerebellar artery aneurysm clip placement. A burr hole is present over where a prior ventriculostomy tube was located.Some punctate foci of susceptibility effect are present along the right half of the splenium of the corpus callosum in linear fashion along a prior ventriculostomy tube tract.There is a mild degree of 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 are clear. The visualized portions of the orbits are intact.MRA brain: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 and is medium sized.. The vertebral arteries are similar in size. The left A1 segment is larger than the right A1 segment. The posterior communicating arteries are medium-sized.There is extracranial origin of the left posterior inferior cerebellar artery.
1.The patient is status post clipping of a right posterior inferior cerebellar artery aneurysm. Please note that local recurrence cannot be evaluated on this exam due to artifacts. There are postsurgical changes present at the craniotomy site.2.There is no evidence for intracranial mass lesion.3.Is no evidence for vasospasm on the prior exam.4.No evidence for acute ischemic cerebral infarction.5.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. 