Reason: ICH noted on head CT History: history of head trauma MRI of the brainThere is T1 signal hyperintensity present within the left geniculated nucleus measuring approximate 7 mm in size. A similar lesion which is T1 hyperintense is present in the right superior colliculus measuring 4 mm. The margins of these two lesions are rather ill-defined. On the T2, FLAIR, SWI and DWI imaging these are not conspicuous. No diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There are a couple periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are of uncertain significance in isolation.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 demonstrate arch opacification of the maxillary sinus is associated with blood products. 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. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size. The left A1 segment is larger than the right A1 segment. There is extracranial origin of the left posterior inferior cerebellar artery. There is no convincing evidence for arteriovenous malformation on this exam.
1.Small lesions identified in the left geniculated nucleus and the right superior colliculus are present. It is suspected that this represents calcified lesions. Although the MR angiogram did not demonstrate that these are vascular lesions, the possibility cannot be excluded on the basis of this exam.2.No evidence for cerebrovascular occlusive disease.3.No evidence for intracranial aneurysm.