Unspecified fall, initial encounter [W19.XXXA], Reason for Study: ^Reason: stroke History: syncope Brain MRINo evidence of acute ischemic or hemorrhagic lesion.There are multifocal bilateral patchy T2/FLAIR high signal intensity lesions on bilateral periventricular white matter and centrum semiovale indicating non-specific small vessel ischemic disease.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. The midline structures and cranial-cervical junction are normal. 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 subtle irregularity of vascular lumen but otherwise normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. There is no significant arterial luminal stenosis. No aneurysm is seen. Bilateral Pcom and Acom arteries are patent. The right ACA A1 segment is hypoplastic.Neck MRA3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate tortuous but 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. Non specific small vessel ischemic disease, as described above.3. Minimal atherosclerotic changes of both intra and extracranial arterial system. No significant arterial luminal stenosis. No intracranial arterial aneurysm. 