Clinical question: Right-sided numbness in face/arm/leg. Signs and symptoms: Same. CTA of intracranial circulation:55 cc of Omnipaque 350 is administered for this exam.3-D reformatted images were obtained from an independent workstation.There is patent bilateral internal carotid arteries across the skull base and in their supraclinoid components. The source and MIP images demonstrate presence of bilateral ophthalmic arteries. Proximal bilateral anterior and middle cerebral arteries are well visualized and unremarkable. The anterior communicating artery is identified and unremarkable. There are patent bilateral normal appearing posterior communicating arteries.There is a hypoplastic right vertebral artery and with a normal appearing right pica branch.A dominant and normal appearing left vertebral artery is identified. Right pica branch and including its origin is unremarkable.Basilar artery is patent. Excellent Normal visualization of bilateral superior cerebellar arteries. There is hypoplastic left P1 secondary to a dominant left posterior communicating artery. Posterior cerebral arteries are unremarkable.CTA of neck:Limited view of the aortic arch and the origins of the major vessels are unremarkable.Right brachial cephalic, origin of right common carotid artery, right common carotid artery are within normal limits. A small smooth and minimally calcific plaque at the origin of right internal carotid artery is noted. There is no hemodynamically significant lumen compromise. The right internal carotid artery is otherwise unremarkable.The left common carotid artery and including its origin are unremarkable. A shallow smooth and minimally calcified plaque at the origin of the left internal carotid artery is also present and bleed no evidence of compromise of lumen. The left internal carotid artery is otherwise unremarkable.Bilateral proximal external carotid arteries are unremarkable.Nonenhanced head CT:Examination demonstrates very subtle suspect that periventricular low attenuation of white matter concerning for possible minimal small vessel ischemic disease of indeterminate age. Recommend further follow-up with a dedicated MRI of brain.There is no evidence of hemorrhage, edema, mass effect, midline shift or hydrocephalus.
1.Non-enhanced CT of brain demonstrates suspected minimal small vessel disease of indeterminate age. Recommend follow-up with a dedicated MRI of brain.2.Unremarkable CTA of intracranial circulation.3.Unremarkable CTA of neck.