weakness, malaise and fatigue No evidence of acute ischemic or hemorrhagic lesion.Multifocal high signal intensities on periventricular and brain stem white matter indicate non specific age indeterminate small vessel ischemic disease.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.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal proximal ICAs and vertebrobasilar system. However, distal intracranial arteries such as MCA M2 segments and PCA P2 and P3 segments appear to be a bit irregular but without evidence of significant luminal stenosis. These findings indicate possible intracranial atherosclerosis.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Multifocal age indeterminate non specific small vessel ischemic disease.3. Evidence of mild intracranial atherosclerosis without large vessel occlusion or significant luminal stenosis. 