 No evidence of acute infarct. T2/FLAIR images demonstrates moderate hyperintensity in the periventricular and the subcortical white matter as well as in the pons, most consistent with chronic small vessel ischemic disease. Few foci of susceptibility are seen in the basal ganglia bilaterally, which may be related to chronic microhemorrhages or mineralization. No evidence of acute hemorrhage. No evidence of intracranial mass effect. No hydrocephalus or extra-axial collections.MR angiography demonstrates patent internal carotid arteries, bilateral ACAs, MCAs, and bilateral PCAs. Left A1 segment is hypoplastic. A 2 mm aneurysm is seen in the anterior communicating artery, projecting posteriorly and to the left. Basilar artery and distal vertebral arteries are patent. Note is made that the right internal carotid artery has a retropharyngeal course.
1. No evidence of acute infarct.2. Moderate chronic small vessel ischemic disease.3. No significant stenosis in the intracranial circulation.4. A 2 mm anterior communicating artery aneurysm is noted projecting posteriorly and to the left.