 Brain MRI:Redemonstrated are a few stable scattered punctate foci of T2 hyperintensity without restricted diffusion, mass effect, or susceptibility abnormality. A previously demonstrated subcentimeter hyperdense focus along the inner table of the right parietal bone, unchanged since 2009, is better seen on today's MRI as a prominent vein. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. Incidental note is made of a partially empty sella. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Sporadic foci of mucosal thickening are present in the paranasal sinuses and the mastoid air cells are clear. Brain MRA: There is antegrade flow within the distal bilateral vertebral arteries, within the basilar artery, distal bilateral internal carotid arteries and carotid siphons and bilateral anterior, middle and posterior cerebral arteries. No arterial stenoses, occlusions or aneurysms are identified. No arteriovenous malformations are identified and there is no evidence for cerebral vasculitis. Neck MRA:There is conventional takeoff of the great vessels from the aortic arch without evidence for stenosis of the origin of the great vessels or of the bilateral vertebral arteries which are codominant. There are no stenoses of the bilateral common, internal or external carotid arteries or of the bilateral carotid bifurcations. There is no evidence for vasculitis, fibromuscular dysplasia or dissection of the carotid or vertebral arterial systems within the neck. Note is made of mild atherosclerotic irregularity throughout the subclavian, common carotid, and bilateral internal carotid arteries without hemodynamically significant stenosis.
1.Stable minimal chronic small vessel ischemic disease.2.Negative MRA of the brain.3.Mild atherosclerotic irregularity throughout the subclavian, common carotid, and bilateral internal carotid arteries without hemodynamically significant stenosis..