Syncope and collapse [780.2], Reason for Study: ^Reason: 31 yo lady with bradycardia and syncope, looking to evaluate for possible neuro cause, r/o Chiari malformation History: lightheadedness, syncope There is no evidence of acute ischemic or hemorrhagic lesion on the scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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. Specifically, there is no evidence of tonsillar herniation through the foramen magnum. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.3D 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. CSF flow study shows normal pulsatile craniofugal and cranio petal flow through the foramen magnum anterior to the brain stem as well as posterior to the brain stem.
1. No evidence of acute ischemic or hemorrhagic lesion. No abnormal contrast enhancement.2. Normal brain MR angiogram and neck MR angiogram.3. Normal CSF flow study. 