status migranosus There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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. Acom artery and bilateral Pcom arteries are patent.The distal right vertebral artery appears to be hypoplastic. No intracranial aneurysm. No intracranial arterial luminal significant stenosis.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. 3D MRV brain post-gadolinium with maximum intensity projections of the superficial/deep intracranial venous drainage demonstrate normal flow enhancement in the superior sagittal sinus, internal cerebral veins, vein of Galen and straight sinus.The left transverse sinus appears to be hypoplastic and the left sigmoid sinus is also smaller than that of the right side. On T2 coronal scan, the left transverse sinus shows high signal intensity and those show some enhancement on Gad, thus indicating age indeterminate thrombus or very slow flow. Considering there is no MR evidence of venous congestive encephalopathy, this lesion is likely represent subclinical and no clinical significance.There are some filling defects within the right transverse and sigmoid sinuses, however, the forward flow appears to be well maintained. Thus those can represent prominent arachnoid granulation or flow related artifacts.
1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Normal intracranial and extracranial arterial system.3. Hypoplastic left transverse and sigmoid sinuses, otherwise unremarkable brain MRV. 