Cerebral aneurysm, nonruptured [I67.1], Reason for Study: ^Reason: Dural AVF hemorrhage, s/p embolization and occlusion in Lebanon and VP shunt placement. Please evaluate status of dural AVF. 3T scanner. History: Neurological deficits s/p hemorrhage Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion. However, there are multiple hemosiderin depositions with associated tissue losses indicating prior hemorrhagic lesions. Those lesions involving left middle cerebellar peduncle, left side lower pons, left midbrain especially lateral aspect and the right side pars marginalis. Especially, the mesial aspect of the left middle cerebellar peduncle shows subtle Gad enhancement, but other lesions do not show any evidence of contrast enhancement.High signal intensities on the left side of medullar on T2/FLAIR indicate Wallerian degeneration.Scattered high signal intensity lesions on bilateral periventricular white matter are non specific.The ventricles, sulci and cisterns are unremarkable. There is no mass effect, edema, midline shift, intra or extra-axial fluid collection, restricted diffusion/acute ischemia. The mastoid air cells are clear.Retention cysts on bilateral maxillary sinuses.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.No evidence of intracranial arterial aneurysm. No evidence of intracranial arterial luminal stenosis.
1. Multifocal hemosiderin depositions but mainly focused on the left side middle cerebellar peduncle extends through the left side of pons to the level of the left side midbrain with associated encephalomalacia as well as the right side pars marginalis as described above. 2. Normal brain MRA.