48 years Female (DOB:10/9/1967)Reason: assess for stroke History: right sided weakness and numbnessPROVIDER/ATTENDING NAME: DAVID HOWES RAYMOND ROOS MRA brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. Since the prior exam periventricular white matter signal hyperintensity on FLAIR and T2 imaging has regressed but not completely resolved.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There are serpiginous flow-voids in the right parietal lobe on susceptibility imaging and on FLAIR MRI which are suggestive of a developmental venous anomaly in the right parietal lobe. This appearance has not changed compared to the prior examNormal 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is some thickening of the posterior longitudinal ligament present. There is some straightening of the normal cervical curvature.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a disc bulge present this level is desiccation and narrowing of the left neural foramen with encroachment of the left-sided exiting nerve roots..At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal. There is some encroachment of the right-sided exiting nerve roots within the neural foramen and result material and osteophytes..At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There is no evidence for acute ischemic cerebral infarction.2.Some ill-defined periventricular white matter lesions are less conspicuous on the current exam compared to the prior. They're nonspecific.3.A subtle lesion in the right parietal lobe is suggested to be a developmental venous anomaly. The appearance has not changed since the prior exam from 2008. Developmental venous anomaly can be confirmed with post contrast imaging if felt to be clinically appropriate.4.There are degenerative changes present in the cervical spine with encroachment of left-sided exiting nerve roots at C2-3 and right-sided exiting nerve roots at C4-5.