67 years Male (DOB:3/11/1949)Reason: post stroke History: amsPROVIDER/ATTENDING NAME: ROBERT A. MULLIKEN MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.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.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium size. The right A1 segment is larger than the left A1 segment. The right posterior communicating artery is small to medium size. The left posterior cerebral artery has fetal origin. The left P1 segment is slightly smaller than the left posterior communicating artery and diameter. The vertebral arteries are similar in size.MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. There is mild narrowing of the proximal right internal carotid artery with what appears to be some smooth plaque along the posterior aspect of the vessel just above the level of the carotid bulb. A smaller degree of plaque is present in the left carotid bulb.
1.No evidence for intracranial aneurysm.2.No evidence for intracranial or extracranial cervicocerebral vascular occlusive disease.3.No evidence for acute ischemic cerebral infarction or posterior reversible encephalopathy syndrome.4.MRI of the brain and MRA of the brain are within normal limits. There is a smaller plaque at the proximal internal carotid arteries.