37 years Female (DOB:2/22/1978)Reason: In October had evidence of a right PICA fusiform dilatation History: right neck pain, right sided sensory lossPROVIDER/ATTENDING NAME: JAMES R. BRORSON JAMES R. BRORSON 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 abnormal mass lesions are appreciated intracranially. 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:There is extracranial origin of the right posterior inferior cerebellar artery. The right posterior inferior cerebellar artery is tortuous proximally and measures up to 2.5 mm in diameter. It subsequently tapers down to 1 mm in diameter and along the fourth ventricle dilates again to 1.5 mm diameter distal to the caudal loop and at the choroidal point. There is a duplicated component of the right posterior inferior cerebellar artery near the choroidal point.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. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.The right posterior inferior cerebellar artery is ectatic proximally at the level of the foramen magnum and along the choroidal point. More detailed information the be gleaned from a conventional angiogram if this is clinically needed. Based on this exam there is no convincing evidence for arteriovenous malformation.2.There is no evidence for cerebral infarction or hemorrhage..