 MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild periventricular and subcortical white matter T2/FLAIR hyperintensity, which is nonspecific but likely related to chronic small vessel ischemic disease. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. Small right air fluid level in the right maxillary sinus and scattered ethmoid air cell opacity. MRA Brain: The intracranial internal carotid arteries demonstrate no significant stenosis. There are scattered atherosclerotic calcifications involving the MCA, ACA and PCA arteries. The middle and anterior cerebral arteries are also patent. Left PCA is fetal origin with small left PCA P1 segment. The vertebral arteries, basilar artery, are without significant stenosis. There is a focal stenosis near the origin of the left PICA. No evidence of aneurysms or vascular malformations.MRA Neck: There is origin of the left common carotid artery from the brachiocephalic artery. The common carotid arteries and cervical internal carotid arteries are without significant stenosis. There is no evidence of stenosis or occlusion. The right vertebral artery is hypoplastic and the origin of the right vertebral artery cannot be adequately evaluated.
1.No evidence of acute intracranial hemorrhage, mass or acute infarct.2.Mild chronic small vessel ischemic disease.3.The origin of the right vertebral artery cannot be assessed. Otherwise scattered atherosclerotic disease without significant flow-limiting stenosis in the neck or intracranial arteries. No intracranial aneurysm, No intracranial arterial stenosis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.