Diagnosis: Hereditary hemorrhagic telangiectasia Other malformations of cerebral vessels. Hereditary hemorrhagic telangiectasia Other malformations of cerebral vesselsClinical question: 3T Scanner, Please screen for brain AVMs, hx of HHTSigns and Symptoms: HHT MRI of the brainThe CSF spaces are appropriate for the patient's stated age with no midline shift. There are several periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially. 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 mucosal thickening in the left maxillary sinus. The visualized portions of the mastoid air cells demonstrate a minor opacity in the left 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 small. The posterior communicating arteries are small. The vertebral arteries are similar in size.
1.There are several periventricular and subcortical white matter signal changes present which are nonspecific. Given the small number there are likely of little clinical significance.. 2.No evidence for cerebrovascular occlusive disease.3.No evidence for intracranial aneurysm , intracranial hemorrhage or intracranial arteriovenous malformation.