Intracerebral hemorrhage [431] / Occlusion and stenosis of carotid artery without mention of cerebral infarction [433.10] / Cerebral aneurysm, nonruptured [437.3], Reason for Study: ^Reason: 3T Scanner, hx ICH, carotid stenosis, aneurysm History: yearly Redemonstration of evidence of left frontal craniotomy.Evidence of encephalomalacia seen on the left superior temporal gyrus as well as part of supramarginal gyrus, again demonstrated, no change since prior scan.Encephalomalacia with ex vacuo changes of the left lateral ventricle especially occipital horn do not show any interval changes since prior scan.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.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. 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 a small left distal ICA likely superior hypophyseal artery aneurysm, no change since prior exam.There is no evidence of another intracranial arterial aneurysm. The left MCA especially distal M1 segment shows luminal narrowing likely about 50% which again shows no interval change since prior exam.The right distal ICA, MCA, bilateral ACA and vertebrobasilar system appear to be normal.
1. Post surgical and embolization status of left distal MCA aneurysm, no interval change of left superior temporal gyrus and left anterior supramarginal gyrus encephalomalacia since prior exam.2. No change of left MCA distal M1 segment narrowing since prior exam.3. No change of a small left superior hypophyseal artery aneurysm since prior exam.4. No other intracranial aneurysm. No acute ischemic or hemorrhagic lesion. 