Headache [R51], Reason for Study: ^Reason: evaluate for meningeal enhancement or possible site of CSF leak History: new headache w/ ?otorrhea/rinorrhea; h/o ischemic stroke Brain MRIMotion artifact degraded exam quality.No evidence of acute ischemic or hemorrhagic lesion.There is a developmental venous anomaly on the left lateral ventricle wall. 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.Brain MRA3D 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. No evidence of acute ischemic or hemorrhagic lesion. No abnormal enhancement.2. Normal brain MRA.Contrast reaction description: Bronchospasm, hives Supervising radiologist: Mikin Patel, M.D. Contrast type: 17 cc of gadolinium contrast was administered. Patient had completed 13 hour premedication protocol. Signs and symptoms: Hypoxia and wheezing Treatment given: 1 mg IM epinephrine 1:1000, 50 mg by mouth Benadryl, and oxygen Discharge instructions given: Dr. Cart called, patient taken to the ER.  