56 years, Female, worsening seizure, rule out brainstem stroke versus cause of worsening seizure. Patient has a vagal nerve stimulator. Brain MRI: No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Tiny nonspecific focus of T2/FLAIR hyperintensity is present in the left subinsular white matter. Brain parenchyma is otherwise unremarkable for age. Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. Brain MRA: The intracranial internal carotid arteries demonstrate no significant stenosis. The middle and anterior cerebral arteries are also patent. The vertebral arteries, basilar artery, and posterior cerebral arteries also are patent with no significant stenosis. No evidence of aneurysms or vascular malformations.
1. Noncontrast brain MRI appears within normal limits for age. No evidence of intracranial hemorrhage, mass, or acute infarct.2. MRA head demonstrates no significant stenosis in the intracranial vasculature.