 Brain MRI:There are a few scattered foci of T2 hyperintensity within periventricular and subcortical white matter. Two lesions within periventricular white matter also demonstrate central T1 hypointensity, and there is no associated susceptibility abnormality or mass effect. There are no similar appearing foci within posterior fossa structures.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. The paranasal sinuses and mastoid air cells are clear. Brain MRA: There is antegrade flow within the distal bilateral vertebral arteries, within the basilar artery, distal bilateral internal carotid arteries and carotid siphons and bilateral anterior, middle and posterior cerebral arteries. Incidental note is made of persistent left fetal PCA circulation as well as a right ophthalmic origin infundibulum. No arterial stenoses, occlusions or aneurysms are identified. No arteriovenous malformations are identified and there is no evidence for cerebral vasculitis. Neck MRA:There is conventional takeoff of the great vessels from the aortic arch without evidence for stenosis of the origin of the great vessels or of the bilateral vertebral arteries which are codominant. There are no stenoses of the bilateral common, internal or external carotid arteries or of the bilateral carotid bifurcations. There is no evidence for vasculitis, fibromuscular dysplasia or dissection of the carotid or vertebral arterial systems within the neck. There are no vascular masses identified.
1.There are a few scattered foci of T2 hyperintensity within periventricular and subcortical white matter. Two lesions within periventricular white matter also demonstrate central T1 hypointensity, and there is no associated susceptibility abnormality or mass effect. There are no similar appearing foci within posterior fossa structures. These are nonspecific in appearance, and the differential diagnosis would most likely include chronic small vessel ischemic disease, although given lesional appearance and patient age, demyelination is also a consideration.2.Negative MRA of the brain.3.Negative MRA of the neck.