seizures, No evidence of acute ischemic or hemorrhagic lesion on this scan.There are patchy high signal intensity lesions on bilateral periventricular white matters indicate non specific small vessel ischemic lesion. Underlying brain shows minimal to mild brain atrophy which could be a bit more prominent than age.The ventricles appear to be a bit prominent but no evidence of occlusive lesion.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The mastoid air cells are clear.Sphenoid sinus as well as bilateral maxillary sinuses show mucosal thickening and fluid level indicating sinusitis.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal distal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. The right Pcom artery is patent and Acom artery is patent but the left Pcom artery is not seen.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The left vertebral artery origin appears to be narrowed about 50%. The right vertebral artery is hypoplastic. Bilateral common carotid, carotid bifurcations, internal/external carotid show tortuous course but do not show any significant luminal narrowing. There is no evidence of intracranial arterial luminal narrowing or arterial aneurysm.
1. No evidence of acute ischemic or hemorrhagic lesion.2. No evidence of intracranial and extracranial craniocervical arterial luminal narrowing.3. No evidence of intracranial aneurysm.4. Non specific white matter changes with mild brain atrophy as described above. 