12 years Female (DOB:11/10/2003)Reason: 3T scanner, please assess for cerebral AVMs, hx of pulmonary AVMs (treated w coils and plugs in 2016) History: hx of nosebleeds \T\ pulmonary AVMs, may have HHTPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD MRI of the brainNo diffusion weighted abnormalities are appreciated. There is artifact emanating from the patient's teeth which obscures some of the pulse sequences such as susceptibility weighted imaging and diffusion-weighted imaging. It also creates distortion along the orbits on MR imaging.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium sized.. The posterior communicating arteries are medium-sized. The vertebral arteries are similar in size.The right posterior inferior cerebellar artery is the dominant vessel and has a prominent vermian branch.
1.No evidence for cerebrovascular occlusive disease.2.There is no convincing evidence for arteriovenous malformation. The vermian branch of the right posterior inferior cerebellar artery appears relatively prominent. This is a nonspecific finding, however, given the artifacts on this exam emanating from the patient's dental hardware perhaps a CT angiogram may help further assess this.3.No evidence for intracranial aneurysm.4.There is no evidence for intracranial mass lesion.5.The exam is somewhat degraded due to metal artifact from dental hardware which may obscure some abnormalities. The orbits and infratemporal fossa are obscured on almost all pulse sequences. Susceptibility imaging and diffusion-weighted imaging there are significant compromise to by the artifact.