Male, 70 years old, with numbness on the left side of the body. History of ruptured aneurysm. Evaluate for change in basilar outpouching. A slitlike hemosiderin stained cavity is redemonstrated spanning the right subinsular and basal ganglia regions, without significant interval change. A punctate focus of susceptibility along the posterior limb of the left internal capsule is unchanged as well.Scattered patchy periventricular and subcortical white matter T2 hyperintensities are again seen without significant interval change. No edema or mass effect is detected. No restricted diffusion is seen. No abnormal extra axial fluid collections are present. The ventricles are normal in size and morphology.Mild/moderate narrowing of the cavernous ICAs is again seen. The ACOM artery is prominent and within normal limits. A moderate focal stenosis of the left A1 segment is unchanged. The left ACA is also generally of smaller caliber than the right, a stable finding. Scattered mild focal stenoses are probably present in the MCA distributions, similar to prior.The right vertebral artery is dominant. The left vertebral artery primarily supplies the PICA. Mild irregularity of the basilar artery is again seen. A 2 mm medially directed apparent outpouching is redemonstrated from the basilar artery at approximately the origin of the left AICA. This finding has not significantly changed. The basilar tip and PCAs are unremarkable. A moderately sized right and small left PCOM artery are present.
1.Stable hemosiderin-stained slitlike cavity in the right subinsular and basal ganglia regions likely representing an old cerebral hemorrhage or hemorrhagic infarct.2.Scattered T2 hyperintensities are not significantly changed likely representing moderate chronic small vessel ischemic disease.3.2 mm outpouching from the mid basilar artery is unchanged.4.Scattered intracranial atherosclerotic disease is unchanged. 