Reason: evaluate for ishemic events History: L face and arm numbness. MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a linear FLAIR signal hyperintensity along the gray matter of the left post central gyrus appproximately 20mm length along the expected location of the hand and arm region of the homunculusThere is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal 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 are clear. The visualized portions of the mastoid air cells are clear. 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. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size. There is fenestration of the right A1 segment.MRV brain:The dural venous sinuses are patent. Straight sinus, internal cerebral veins and basal veins are identified and appear patent. The right transverse and sigmoid sinuses are larger than their left counterparts.
1.There is a subtle cortically based lesion along the left post-central gyrus. The cause is not known. In general this appears to be in a chronic stage. 2.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. No evidence for cerebrovascular occlusive disease.3.No evidence for intracranial aneurysm.4.MR venogram of the brain is within normal limits5.No evidence for acute ischemic infarction.6.The patient refused contrast administration.