 MRI BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are scattered punctate foci and confluent areas of abnormal T2 hyperintensity within the periventricular and subcortical white matter as well as the pons. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are punctate foci of susceptibility effect in the right thalamus, consistent with hemosiderin deposition from chronic microhemorrhage. The skull and extracranial soft tissues are unremarkable. There is mild mucosal thickening of the bilateral frontal, ethmoid, maxillary, and sphenoid sinuses.MRA BRAIN: The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis. There is a 2 to 3 mm outpouching at the origin of the left posterior communicating artery.
1. Chronic small vessel ischemic disease, but no evidence of intracranial hemorrhage or acute infarct. 2. Prominent infundibulum versus aneurysm at the left posterior communicating artery origin. 3. No evidence of significant stenosis affecting the Circle of Willis vessels.