known sickle cell disease patient evaluation and follow up. Evaluate for moyamoya syndrome. There is focal high signal intensity on FLAIR image on the right side cuneus lateral aspect white matter (seris 6, image 15/28). However there was subtle increased signal intensity on prior FLAIR images and there was no evidence of enhancement on today's images. Thus, this finding is most likely represent non specific finding.Otherwise there is no evidence of acute ischemic or hemorrhagic lesion. No abnormal enhancement either.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. Normal flow voids are identified in the major intracranial vessels. 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 normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.
1. Subtle increased signal intensity on the right cuneus white matter which likely represent non specific lesion as described above. 2. Otherwise unremarkable brain MRI and normal brain MRA.