 BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are no areas of abnormal parenchymal signal. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Mild mucosal thickening is present within the maxillary and ethmoid sinuses. The skull and scalp soft tissues are unremarkable.MRA HEAD: The intracranial internal carotid arteries are normal in course and caliber. The left A1 segment is hypoplastic. 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 or aneurysm.MRA NECK: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. The vertebral arteries are co-dominant. There is no evidence of flow-limiting stenosis or occlusion.MRV was partially performed. The images give the appearance of decreased flow in the left sigmoid sinus. This could be artifactual. 2-D time-of-flight oblique images were not performed which could help further assess this.The right sigmoid sinus, transverse sinus and jugular bulb are significantly smaller relative to the left-sided counterparts based on the recent CT exam.
1.No evidence of ischemic infarction or other acute intracranial abnormality.2.Patent arteries within the head and neck without evidence of aneurysm or flow-limiting stenosis.3.Please note that the MRV portion of this examination will be reported separately following acquisition of additional images. Specifically the left sigmoid sinus is not adequately imaged on this exam.