Migraine, unspecified, intractable, without status migrainosus [G43.919], Reason for Study: ^Reason: evaluate for change in size of aneurysm ant comm 3mm seen in Aug 2013 at OSH History: consistent headaches for almost 1 week Brain MRINo evidence of acute ischemic or hemorrhagic lesion. A couple of T2/FLAIR high signal intensity lesions on the left frontal lobe which are nonspecific.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, or abnormal contrast enhancement. 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.Brain MRA3D time of flight MOTSA technique maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. There is no evidence of intracranial arterial aneurysm. There is no evidence of intracranial arterial luminal stenosis.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Nonspecific white matter T2/FLAIR high signal intensity lesions.3. No evidence of intracranial arterial aneurysm. No intracranial arterial luminal stenosis.Comment: Although clinical history shows about 3 mm aneurysm seen in August 2013 outside images, this could be related to the sensitivity of different imaging modality for the detection of small intracranial arterial lesion. Therefore, if clinically indicated, head CTA can be considered for further imaging investigation.