Female, 15 years old, with headache. Artifact presumably arising from orthodontic braces degrades image quality particularly on the diffusion-weighted, susceptibility weighted, and FLAIR images. Given this limitation, the following observations are made.Brain parenchymal morphology is within normal limits. No definite evidence of restricted diffusion or other significant parenchymal signal abnormality is seen. No edema or mass effect is detected. No intracranial hemorrhage or abnormal extra-axial fluid is observed. The ventricular system is normal in size and morphology.On MRA imaging of the head, an apparent 4 mm outpouching is seen along the anterior genu of the left ICA. While it is possible that this represents artifact or vascular tortuosity, it is observed again on the MRV sequence. The intracranial arterial structures are otherwise within normal limits. No significant stenosis or vascular occlusion is identified.On MRV imaging of the head, again a small vascular outpouching is suspected at the level of the anterior genu of the left ICA. The dural venous sinuses and deep venous structures of the brain are well visualized and patent.On MRA imaging of the neck, no significant vascular abnormalities are detected.
1. Allowing for artifact induced by orthodontic braces, no significant brain parenchymal abnormalities are detected.2. On MRA imaging of the head, a 4 mm vascular outpouching is suspected at the level of the anterior genu of the left ICA, also confirmed on MRV imaging. While this could reflect an artifact or vascular tortuosity, the possibility that this may represent a small aneurysm must be considered. Confirmation of this finding with CTA of the head is recommended.3. On MRV imaging of the head, no dural venous or deep venous thrombosis is suspected.4. On MRA imaging of the neck, no significant vascular abnormalities are detected.