Dissection of vertebral artery. The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.There is a 12 x 5 mm extra-axial lesion adjacent to the left parietal lobe which enhances following contrast administration.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 and demonstrate that the left maxillary sinus is opacified and small. The visualized portions of the mastoid air cells are clear. The floor of the left orbit droops into the left maxillary sinus and is suggestive of a prior blowout fracture. There is mild enophthalmus suspected on the left .
1.There is no evidence of acute ischemic cerebral infarction. 2.There is a small extra-axial lesion adjacent to the left parietal lobe. One possibility is that this represents a meningioma. 3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related.4.Findings suggest an old left-sided orbital bloout wall fracture with silent sinus syndrome on the adjacent left side.5.The patient's reported vertebral dissection is not appreciated on this exam, though, the entire vertebral artery courses are not included on this exam.