9-year-old girl with chromosomal abnormality. Presented with facial droop. To Rule out transient ischemic attack or stroke. The exam was done without sedation and is limited by patient motion.Brain MRI:The brain demonstrates no diffusion restriction or susceptibility effect. A very subtle questioned tiny linear focus of increased signal in the right side of the pons on the diffusion weighted imaging with subtle ADC hypointensity is probably artifactual unless the patient has symptoms/signs directly correlating to this. Also, there are multiple foci of similar appearing low signal on ADC elsewhere in the pons, as well as right lateral to the questioned focus with similar configuration, which also increases the likelihood of the findings being artifactual. Gray-white differentiation is preserved. A very tiny focus of T2 hyperintensity in the right parietal periventricular white matter is nonspecific. There is no focal brain lesion, otherwise. There is no mass effect or midline shift. The ventricles and the other CSF-containing spaces remain unremarkable.There is mild to moderate mucosal thickening in the maxillary and anterior ethmoid sinuses. The orbits are unremarkable. There is no destructive skull lesion.Head MRA:The MR angiography is markedly limited by patient motion. While vessel caliber and morphology cannot be accurately assessed, there is no high-grade major vessel narrowing or occlusion. The basilar artery shows a long segment fenestration. There is also one or a dominant pericallosal artery arising from the right side. There is no left posterior communicating artery visualized. These are congenital variations.
1.Study is limited by patient motion as described above.2.There is no definite brain infarct or hemorrhage. The subtle tiny apparent diffusion weighted imaging finding in the right side of the pons is likely artifactual, unless can be directly correlated to patient's symptoms and signs as described above.3.There is no major vessel occlusion or flow-limiting narrowing. The MR angiography is otherwise of limited value given motion.