Other specified disorders of muscle [M62.89], Reason for Study: ^Reason: stroke r/o History: slurred speech, R \T\ L facial droop, R-sided weakness Brain MRI:No evidence of acute ischemic or hemorrhagic lesion.Patchy scattered high signal intensity lesions on FLAIR/T2 at bilateral periventricular white matter and centrum semiovale are non specific.The ventricles, sulci and cisterns are symmetric and unremarkable. 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. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate about 3mm sized luminal bulging at the right MCA distal M1 segment - MCA bifurcation which suggest possible intracranial arterial aneurysm. The lesion is better seen on Neck MRA scan.Otherwise normal ICAs, left MCAs and ACAs. Vertebrobasilar system appears to be normal.Neck MRA3D 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 vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. Again, right MCA distal M1 - MCA bifurcation area shows round luminal bulging which may suggest possible intracranial aneurysm. However, overlapped MCA branches cannot be completely excluded.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Non specific white matter lesions.3. Possible right MCA distal M1-MCA bifurcation aneurysm. Head CT angiography can be considered for further imaging evaluation. 