56 years Female (DOB:9/22/1959)Reason: please evaluate known aneurysm and microhemorrhages, compare to prior images History: short-term aneurysm and microhemorrhage surveillance; altered mental statusPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD MRI of the brainNo diffusion weighted abnormalities are appreciated.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. A punctate foci of signal loss and susceptibility weighted imaging along the subcortical white matter of the temporal lobes as well as along the periventricular white matter and along the left internal capsule as well as the left medial temporal lobe in the corpus callosum.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 demonstrate an opacity in the left sphenoid sinus. The visualized portions of the mastoid air cells are partially opacified. The visualized portions of the orbits are intact.MRA brain:There is a left posterior communicating artery aneurysm present measuring 7 x 5 mm axial dimensions and stable compared to the prior exam. The aneurysm is directed inferiorly and posteriorly and has a relatively wider neck.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. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.No evidence for cerebrovascular occlusive disease.2.Stable 7mm left posterior communicating artery aneurysm3.There are multiple microhemorrhages present intracranially this pattern is most compatible with hypertension but nonspecific.