right side weakness There is no evidence of acute ischemic or hemorrhagic lesion on this scan.Multifocal patchy high signal lesions on bilateral periventricular white matter indicate non specific small vessel disease.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 paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal flow enhancement in bilateral distal ICAs, ACAs and MCAs. Vertebrobasilar system appears to be normal.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are difficult to evaluate due to signal loss. The signal loss is more likely related to bilateral shoulders and overlapped bilateral jugular veins, not necessarily related to vertebral ostial stenosis.There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries.
1. There is no evidence of acute ischemic or hemorrhagic lesion on this scan.2. Normal intracranial and extracranial MRAs. 