Female, 20 years old, with headaches, increasing in frequency, with syncope. The diffusion and susceptibility weighted sequences are degraded by artifact presumably arising from orthodontic hardware. The other sequences are of good quality.Brain parenchymal morphology is within normal limits. No focal signal abnormality, edema or mass effect is detected. No pathologic parenchymal enhancement is seen. Note is made of prominent vascularity between the cerebellar tonsils and at the level of the foramen of Magendie. No intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology.
1.No acute intracranial abnormality and no definite findings to account for the patient's symptoms.2.Note is made of prominent vascularity between the cerebellar tonsils which is of uncertain significance. This could represent normal anatomic variation although a shunting lesion such as a dural AV fistula could present similarly. Dedicated vascular imaging can be considered as clinically warranted.