Recurrent events suggestive of brainstem ischemia. Most recently double vision for two weeks. Enhanced CTA of intracranial circulation :65 cc of Omnipaque 350 is administered.3-D reformatted images were obtained utilizing an independent workstation and where utilized for interpretation.There are patent and normal appearing bilateral intracranial vertebral arteries, bilateral pica branches, basilar artery, posterior cerebral arteries and superior cerebellar arteries.There is normal anatomical variation of the left superior cerebellar artery arising from proximal left posterior cerebral artery.There are also patent bilateral internal carotid arteries across the skull base. The supraclinoid components of internal carotid arteries are unremarkable. Both anterior and middle cerebral arteries are visualized. There is focal slight ectasia of the proximal A2 components of the left anterior cerebral artery. The exact etiology of this finding is not clear. There is also no evidence of any additional foci of muscular cavitation. The finding could be secondary to atherosclerotic disease. Recommend follow-up.CTA of neck:Limited view of lower tic arch and the origins of the major vessels are unremarkable. There is anatomical variation a bovine arch evident by left common carotid artery arising from the cephalic branch.There are normal bilateral common carotid arteries, internal carotid arteries and including their origins.There is also normal appearing bilateral vertebral arteries and including their origins.Nonenhanced head CT:There is no detectable intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus.Cortical sulci, ventricular system, CSF cisterns all remain within normal limits. There are bilateral parietal subtle linear low attenuation that are suspected for perivascular spaces. Remote possibility of small vessel ischemic disease cannot be ruled out.Considering provided clinical data recommend an MRI examination for better evaluation.
1.Non-infused head CT is unremarkable. Considering provided clinical data and patient's symptomatology recommend brain MRI examination for further assessment.2.Unremarkable CTA of neck.3.CTA of intracranial circulation demonstrates a focal segmental dilatation of proximal left A2 segment of anterior cerebral artery. The exact etiology of this finding is not clear. Finding however could represent atherosclerotic disease. Recommend further follow.4.Unremarkable CTA of intracranial circulation otherwise.