Clinical question: 28-year-old female with chronic history of migraines, escalating a recent month. Family history of aneurysm. Rule out mass, increased intracranial pressure. Signs and symptoms: Severe headache. Pre and post enhanced brain MRI:Negative diffusion weighted series.Examination demonstrate normal anatomical morphology as well as signal intensity of brain parenchyma on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.Post infused images demonstrate a multi branch is small vascular enhancement in the right frontal and basal ganglia consistent with a congenital developmental venous anomaly without clinical significance. This finding is not associated with any detectable cavernoma. No detectable abnormal parenchymal or leptomeningeal enhancement.Signal void of major intracranial arterial branches are identified and unremarkable. Note should be made that this exam cannot exclude possibility of aneurysm.Unremarkable calvarium and orbits without detectable abnormal enhancement.All visualized paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
1.Pre- and post enhanced brain MRI demonstrate a small right basal ganglionic/frontal lobe congenital developmental venous anomaly and unremarkable otherwise.2.Note should be made that MRI cannot exclude possibility of aneurysm.3.Well-pneumatized paranasal sinuses and bilateral mastoid air cells and middle ear cavities and unremarkable calvarium.