Dizziness and giddiness [R42], Reason for Study: ^Reason: stroke, embolus History: dizziness, gait unsteadiness, blurred vision79 years Female (DOB:8/28/1937)Reason: see mra neck History: see mra neckPROVIDER/ATTENDING NAME: MICHAEL ANDREW WARD DAVID G. BEISER Brain MRINo evidence of acute ischemic or hemorrhagic lesion.Multifocal scattered FLAIR/T2 high signal intensity lesions on bilateral periventricular white matter and centrum semiovale indicate non specific small vessel ischemic disease.The ventricles, sulci and cisterns are unremarkable. 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. 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.Neck MRA3D MRA neck non contrast TOF images with maximum intensity projections of the cervical vasculature demonstrate limited view especially aortic arch level, however, no evidence of significant luminal stenosis or occlusion. The vertebral artery origins cannot be evaluated. There is no definitive evidence of abnormal finding on bilateral common carotid, carotid bifurcations, internal/external carotid.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Non specific small vessel ischemic disease.3. Normal brain MRA.4. Limited examination for neck MRA but no definitive evidence of abnormality. This is due to technical limitation of non contrast MRA of neck, thus if clinically indicated, neck CTA or contrast enhanced MRA can be considered. 