anoxic brain injury, posterior circulation stroke, unresponsive There is no evidence of acute ischemic or hemorrhagic lesion on this scan.FLAIR images show patchy bilateral high signal intensity lesion on periventricular white matter indicating non specific small vessel disease. Gradient echo images show various sized susceptibility lesions on bilateral hemispheres white matter. Differential diagnosis include amyloid angiopathy, small chronic hemorrhagic lesions, parenchymal calcifications or cavernomas less likely. 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. 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 bilateral ICAs, MCAs and ACAs. Bilateral PCAs are fetal origin. Vertebrobasilar system appears to be normal. No aneurysm. No intracranial arterial luminal stenosis.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. Bilateral vertebral artery origins are not shown but source image analysis revealed no significant luminal stenosis.
1. No evidence of acute ischemic stroke. No evidence of acute hemorrhagic lesion.2. Non specific small vessel ischemic disease.3. Multiple lesions on bilateral hemispheres demonstrating susceptibility artifacts, possibilities include amyloid angiopathy, multiple chronic hemorrhagic lesions, multiple calcifications or cavernomas less likely.4. No intracranial aneurysm. No intracranial arterial stenosis. Normal extracranial cervicocarotid arterial system. 