55 years Female (DOB:7/29/1960)Reason: h/o R sided weakness and aphasia, eval for stroke History: see abovePROVIDER/ATTENDING NAME: IMRE M NOTH IMRE M NOTH MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrates mucosal thickening.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.The exam is significantly degraded due to patient motion. Susceptibility imaging is significantly limited.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal right vertebral artery, the basilar artery and the proximal anterior, middle and posterior cerebral arteries. The left vertebral artery is not identified intracranially.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. Anterior communicating artery cannot be excluded based on a general appearance of the anterior communicating artery region. The right posterior communicating artery is relatively small but can be identified. The left posterior cerebral artery has fetal origin. The vertebral arteries are similar in size. The exam is significantly degraded due to patient motion.MRA neck: On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. The left vertebral artery is not identifiedThe exam is significantly degraded due to patient motion. The origins of the great vessels from the aortic arch are not included.MRI neck:Soft tissues of the neck exam is severely limited due to patient motion. No obvious mass lesion is identified in the soft tissues of the neck.
1.The exam is significantly degraded due to patient motion. This may obscure more subtle abnormalities on the MRI of the brain, the MRA of the brain, soft tissues of the neck study and the MRA of the neck.. 2.There is some suspicion that the anterior communicating artery aneurysm may or may not exist. If clinically appropriate a CT angiogram when the patient is able to tolerate exams are an MR angiogram of the patient is able to tolerate may be of further benefit in evaluating.3.The left vertebral artery is not readily identified. The possibility of left vertebral artery disease cannot be excluded. Please note that motion artifact limits evaluation. It is possible the left vertebral artery is simply hypoplastic.4.There is no evidence for acute ischemic cerebral infarction.