Left-sided numbness and weakness There is no evidence of acute ischemic or hemorrhagic lesion on this scan.On gadolinium enhanced scan, there is a prominent vascular structure on the left frontal lobe starting from the left lateral ventricle ependymal surface appears to be connecting to the superior sagittal sinus. The course and configuration appear to be suggesting developmental venous anomaly.Patch multifocal high signal intensity on periventricular white matter on FLAIR images indicate mild to moderate nonspecific small vessel ischemic disease.There are also multifocal areas with tissue loss including left caudate nucleus right external capsule left external capsule pons right middle cerebellar peduncle and the right and basal ganglia indicating prior lacunar infarct.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate slightly irregular arterial lumen without significant luminal stenosis on ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. No evidence of intracranial aneurysm. No significant luminal stenosis.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Mild to moderate nonspecific small vessel ischemic disease with multifocal chronic lacunar infarctions.3. Prominent venous structure arising from the left lateral ventricle courses through the left frontal lobe indicates possibility of developmental venous anomaly.4. Mild atherosclerotic changes of intracranial arterial system.5. No evidence of intracranial arterial aneurysm, no evidence of intracranial and extracranial arterial luminal stenosis.