Other headache syndromes(339.89) [339.89] / Common variable immunodeficiency [279.06] / Unspecified cerebral artery occlusion with cerebral infarction [434.91], Reason for Study: ^Reason: IVIG, HA History: HA There is focal tissue loss on the left mesial thalami without evidence of hemosiderin deposition indicating possible chronic ischemic infarction with encephalomalacia.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Bilateral maxillary sinus show opacifications.3D 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.3D MRV brain post-gadolinium with maximum intensity projections of the superficial/deep intracranial venous drainage demonstrate hypoplastic left transverse and transverse-sigmoid sinus junction. The right transverse sinus, right sigmoid sinus, superior sagittal sinus and torcular appears to be normal. Unilateral hypoplastic sinus especially transverse sinus could be regarded as a normal variation, however, this could also be a finding of idiopathic intracranial hypertension.
1. Encephalomalacia on the left mesial thalamus indicating chronic ischemic infarction. Otherwise no evidence of acute ischemic or hemorrhagic lesion on this scan.2. Normal brain MRA3. Hypoplastic left transverse and transverse-sigmoid sinus junction. This could represent a normal variation. 