Headache [R51], Reason for Study: ^Reason: HA with exercise, eval for space occupying lesion History: as above Brain MRISignificant metallic artifacts from maxillofacial area degraded exam quality.There is no evidence of acute ischemic or hemorrhagic lesion although on limited examination coverage. 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 are normal.There is about 3mm downward placement of bilateral cerebellar tonsils through the foramen magnum. The paranasal sinuses and mastoid air cells are clear.Brain MRASignificant metallic artifacts degraded inflow enhancement signal intensities especially anterior aspects of circle of Willis.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate no evidence of intracranial aneurysm, no significant luminal stenosis.However, due to metallic artifacts, precise evaluation of intracranial arterial system is not possible. Thus, if clinically indicated, head CTA can be considered for further imaging evaluation.
1. Limited examination due to significant metallic artifacts.2. No evidence of acute ischemic or hemorrhagic lesion. No abnormal enhancement.3. No evidence of intracranial arterial abnormality.Comment: head CTA can be considered for further imaging evaluation for intracranial arterial system if clinically indicated. 