75 years Male (DOB:3/3/1940)Reason: cognitive decline, h/o diabetes - assess for cerebrovascular disease History: memory declinePROVIDER/ATTENDING NAME: JAMES A. MASTRIANNI JAMES A. MASTRIANNI The right basal vein of Rosenthal is markedly dilated along its junction with the deep middle cerebral vein. There is no associated aneurysm present involving the right basal vein of Rosenthal immediately adjacent to the right middle cerebral artery M1 segment origin. This aneurysm measures approximately 11 mm in size. There is some suggestion of some dilated left ventricular striate arteries at the right M1 segment.The CSF spaces are appropriate for the patient's stated age with no midline shift. The Excel note is made of cavum septum pellucidum and cavum vergae.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.
1.A dilated the right basal vein of Rosenthal, an aneurysm and dilated contiguous right arteries suggest arteriovenous malformation with aneurysm formation. An MRA of the brain will be helpful to further evaluate this. This finding was communicated to Dr. Mastrianni at the time the exam. The patient was recalled before the left the MRI area so that the MR angiogram could be performed.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 