55 years Female (DOB:1/5/1961)Reason: evaluate for stroke History: transient bilateral leg and L arm weakness, L ICA stenosis 50 - 69% per US at OSHPROVIDER/ATTENDING NAME: SARAH E PAYNE MADHU C YARLAGADDA MRI of the brainNo diffusion weighted abnormalities are appreciated. The cerebellar tonsils extend below the level of the foramen magnum by approximately 10 mm.The CSF spaces are appropriate for the patient's stated age with no midline shift. 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 demonstrate some mild mucosal thickening. The visualized portions of the mastoid air cells demonstrate minor opacities along the right mastoid air cells. The visualized portions of the orbits are intact.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 identified and is medium size. The right posterior communicating artery is medium-sized. The left posterior cerebral artery has fetal origin. The left P1 segment is medium-sized. There is infundibulum at the origin of the posterior communicating arteries bilaterally. The vertebral arteries are similar in size.MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. The cerebellar tonsils extend below the level of the foramen magnum by approximately 10 mm.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. There is a perineural cyst present on the left at T1-2 lateral to the neural foramen. This is not entirely exam.
1.No evidence for intracranial aneurysm.2.No evidence for intracranial or extracranial cervicocerebral vascular occlusive disease.3.There is no evidence for acute cerebral infarction.4.There is no compromise of the cervical spinal canal or exiting nerve roots appreciated.5.Chiari I malformation without associated syrinx or ventriculomegaly.