 MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. 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, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA Brain: The intracranial internal carotid, middle and anterior cerebral arteries are patent. The AComA is not well seen by MRI. The left PComA is small. The right PComA is medium sized. The right vertebral artery is bigger than the left but both are patent. The basilar artery and posterior cerebral arteries are patent with no significant stenosis. No evidence of aneurysms or vascular malformations.MRA Neck: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. The left vertebral artery is smaller than the right and arises from a common origin with the left subclavian artery from the aorta. Both vertebral artery origins are patent. There is no evidence of stenosis or occlusion. MRI C-Spine:The craniovertebral junction appears within normal limits. The cervical spine alignment is maintained and the cervical vertebral bodies and disc spaces are appropriate in height. The bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology. The vertebral artery flow voids appear to be intact. No significant compromise to the spinal canal or neural foramina. The paraspinous soft tissue structures appear within normal limits.
1.No evidence of acute intracranial hemorrhage, mass or abnormal mass lesion.2.No evidence for cervicocerebral occlusive disease, including no evidence of vertebral or carotid artery dissection.3.No evidence for cervical spinal cord compression or cord signal abnormality. There is no significant compromise to cervical spinal canal or neural foramina4.Tonsilar ectopia which may represent an incidental finding.