3T scannerReason: 3T scanner, aneurysm follow up History: L side headaches starting at temple and radiating back, started 3 weeks ago8/13/194174 yearsFemale MRI orbits:The eyeballs are intact. No intraconal or extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .IACThe patient status post left temporal bone surgery including mastoidectomy. There is a fat graft present within the surgical site at the left temporal bone.No abnormal foci of enhancement are appreciated within the internal auditory canals. The cochlea and semicircular canals appear intact. The cochlear nerve can be followed bilaterally tracking into the cochlea. The modiolus is well formed bilaterally.No abnormal enhancing lesions are appreciated at the cerebellopontine angle cisterns nor the internal auditory canals.MRA brain: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 a 5 mm wide neck aneurysm along the distal left internal carotid artery originating at the level of the clinoid process which is directed laterally and slightly superiorly and abuts the left gyrus rectus and adjacent left orbital gyrus.The anterior communicating artery is identified and is medium size. The posterior communicating arteries are intact. There is fenestration of the basilar artery present. The left vertebral artery is larger than the right vertebral artery.
1.There is a 5 mm wide neck aneurysm along the distal left internal carotid artery originating at the level of the clinoid process which is directed laterally and slightly superiorly and abuts the left gyrus rectus and adjacent left orbital gyrus. This is stable compared to the previous exam.2.The patient status post left temporal bone surgery.3.There is no evidence for internal auditory canal mass.4.There is no evidence for an intraorbital mass.