Aneurysm of vertebral artery [I72.6], Reason for Study: ^Reason: eval vertebral artery aneurysm History: unsteady gait, Rt vert artery aneurysm 65 years Female (DOB:10/25/1951)Reason: eval vertebral artery aneurysm History: unsteady gait, Rt vert artery aneurysmPROVIDER/ATTENDING NAME: DOROTA K HAVLIN Brain MRIThere is about 19mm sized right distal vertebral artery aneurysm which shows T1 and T2 high signal intensity portion on the dome indicating possible partially thrombosed or flow related artifacts.There is also associated adjacent brain parenchyma T2/FLAIR high signal intensity lesions in particular on the right cerebellar hemisphere as well as right middle cerebellar peduncle indicating aneurysm related brain parenchymal edema.There is no evidence of acute ischemic or hemorrhagic lesion.There are multifocal lacunar infarcts involving bilateral basal ganglia left centrum semiovale.Patchy T2/FLAIR high signal intensity lesions on bilateral periventricular white matter are seen, indicate nonspecific small vessel ischemic disease.The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate dominant right vertebral artery with about 19mm sized distal right vertebral artery aneurysm. The right PICA arose at the level of C1 arch but likely intradural origin.No other aneurysm is seen.Bilateral Pcom arteries and Acom artery are patent.Ventricular system appears to be within normal limits.Multiple supra and infra tentorial susceptibility lesions are seen indicating either chronic petechial hemorrhage or parenchymal mineralizations.
1. About 19mm sized right distal vertebral artery aneurysm with adjacent brain parenchymal T11/FLAIR high signal intensity lesion indicating parenchymal edema.2. No evidence of acute ischemic or hemorrhagic lesion.3. Non specific small vessel ischemic disease.4. Multifocal parenchymal susceptibility lesions indicate either chronic petechial hemorrhage or mineralizations.