49 years Female (DOB:7/10/1966)Reason: assess for FLAIR changes compatible with SAH History: increasing RBCs on LPPROVIDER/ATTENDING NAME: JAMES A MASTRIANNI JAMES A MASTRIANNI MRI of the brainThere are several periventricular and and subcortical white matter signal hyperintensities identified on FLAIR MRI without diffusion restriction.The CSF spaces are appropriate for the patient's stated age with no midline shift. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate some mild mucosal thickening in the right maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Embolic occlusion coils are present at the patient's right anterior choroidal bilobed aneurysm (which is embedded into the medial aspect of the right temporal lobe) and the patient's mid-basilar aneurysm. The anterior choroidal artery remains patent. The appearance is stable since prior exams with a minimal remnant.There is redemonstration of a 2mm right ophthalmic artery aneurysm at the origin of the right ophthalmic artery. There is redemonstration of a left superior cerebellar origin 1 mm aneurysm. There is redemonstration of a 1 mm left PCOMA aneurysm.Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.The anterior communicating artery is identified. The posterior communicating arteries are small. The left vertebral artery is slightly smaller than the right vertebral artery.
1.No evidence for cerebrovascular occlusion.2.Status post embolic coil occlusion of a right anterior choroidal artery aneurysm with no evidence for recanalization at this time and no change since the prior MRA. This aneurysm is embedded in the right temporal lobe.3.Status post embolization of a basilar/left AICA origin aneurysm with minimal evidence for recurrence.4.There is redemonstration of a 2mm right ophthalmic artery aneurysm at the origin of the right ophthalmic artery. This indicates evolution of previously noted microinfarcts.5.There is redemonstration of a left superior cerebellar origin 1 mm aneurysm.6.There is redemonstration of a 1 mm left PCOMA aneurysm.7.Several periventricular and subcortical white matter lesions are present which are stable relative to the prior exam