Reason: intracranial stenosis? History: imbalance MRI of the brainThere is a 5 mm thick by 22-mm wide extra-axial lesion which is bright on flair and T1 weighted imaging.Small focus of encephalomalacia present along the right orbital gyrus which is associated with some susceptibility effect and superficial siderosis .There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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. The eyeball lenses are thin.MRA brain: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 small in. The posterior communicating arteries are identified. The left posterior communicating artery is fairly large whereas the right posterior communicating artery is a very small. The vertebral arteries are similar in size.
1.A small extra-axial lesion is present adjacent to the left frontal lobe. There is no associated mass effect. Differential considerations include a small subacute hematoma.2.Small focus of encephalomalacia and he right orbital gyrus is present. This specific location and is often associated with posttraumatic injury.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 