Status post embolization and SRS intervention for dural AV fistula. 1 year follow-up. BRAIN MRI:Confluent and patchy periventricular frontoparietal white-matter T2-hyperintensity is not significant changed and probably reflects chronic microvascular ischemia. There is no abnormal brain diffusion restriction or susceptibility effect to indicate acute infarct or intracranial hemorrhage. There is no mass-effect, midline shift or brain herniation. The ventricles and the other CSF-containing spaces are normal in size.There is no gross orbital abnormality. There is minimal mucosal thickening in the ethmoid sinuses. The included paranasal sinuses are clear. Mastoid air cells are clear as well. Multiple heterogeneously T1-hyperintense, T2-hypointense scalp nodules are unchanged and may reflect inclusion cysts.CRANIAL MR ANGIOGRAPHY:The small arteries traveling along the left jugular bulb, which probably reflect jugular branches of the ascending pharyngeal artery, are unchanged. There are also small vessels along the left sigmoid sinus, which are not significantly changed. The occipital arteries are now more symmetric in size. Otherwise, the intracranial arteries remain unchanged without significant stenosis or aneurysm.
1.Findings suggest a small residual arteriovenous fistula involving the jugular branch of the ascending pharyngeal artery. This has not changed substantially since the July exam.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. They're stable compared to the prior exam.