Evaluate for steno-occlusive disease, etiology of TIA: episode of aphasia and amnesia. Brain MRI: There is no evidence of intracranial hemorrhage or acute infarct. There two punctate fat signal intensity lesions in the midline of the posterior suprasellar cistern and interpeduncular cistern. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. 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. The orbits are grossly unremarkable. There is a small left maxillary sinus retention cyst. There is fluid within the pneumatized left petrous apex. Brain MRA: The vertebrobasilar system is relatively diminutive diffusely. Otherwise, there is no evidence of significant steno-occlusive lesions or saccular aneurysms.Neck MRA: There is a two vessel arch. There is no evidence of significant steno-occlusive lesions.
1. No evidence of intracranial hemorrhage or acute infarct. 2. The vertebrobasilar system is relatively diminutive diffusely, but without focal steno-occlusive lesions.3. No evidence of significant steno-occlusive lesions in the major neck arteries.4. Two punctate lipid-containing lesions in the midline of the posterior suprasellar cistern and interpeduncular cistern are compatible with a lipomas or dermoids. 5. Left petrous apex effusion.