Diagnosis: Unspecified transient cerebral ischemiaClinical question: Reversal of vascular stenoses seen in May and June?Signs and Symptoms: Occasional headachesComments: SCD, SAH with ? vasospasm changes in May 2015. | MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.The anterior communicating artery is medium-sized. There is extracranial origin of the left posterior inferior cerebral artery. The posterior communicating arteries are identified and are small. Curiously the right posterior communicating artery is smaller on the current exam than it was 11/6/2013 and 5/24/2015 exam exam.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.There are small hypointense lesions present in the caudate nuclei bilaterally as well as the periventricular white matter and some encephalomalacia in the left middle frontal gyrus which are probably better appreciated on recent MRI exam.
There is no evidence for intracranial aneurysm or intracranial cerebrovascular occlusive disease. Curiously compared to the prior exams the caliber of the right posterior communicating artery has decreased.