Unspecified cerebral artery occlusion with cerebral infarction [434.91] / Cerebral aneurysm, nonruptured [437.3] / Aphasia [784.3] / Memory loss [780.93], Reason for Study: ^Reason: hx of therapeutic carotid artery occlusion for aneurysm, chronic ischemia. Significant metallic artifacts on the left skull base which reflects prior coil embolization of the left ICA and aneurysm.There is no MR evidence of acute ischemic or hemorrhagic lesion on this scan.There is evidence of focal parenchymal chronic hemorrhage on the right centrum semiovale and tissue losses indicating chronic ischemic lesions on the left centrum semiovale. Underlying brain shows multiple scattered high signal intensity lesions on FLAIR images around periventricular white matter indicating non specific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal right ICA, bilateral MCAs and ACAs. Distal left ICA from the origin of the left ophthalmic artery is visualized. Vertebrobasilar system appears to be normal.
1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. The left distal ICA is reconstituted through both Acom and left Pcom arteries, no evidence arterial luminal stenosis or evidence of intracranial arterial aneurysm.3. Chronic hemorrhagic lesion on the right centrum semiovale and chronic ischemic lesion on the left centrum semiovale as described above. 