Dizziness and dysarthria. Evaluate for ischemia. MRI:Patient motion limits exam and the exam was terminated early due to to patient inability to continue. No restricted diffusion to indicate acute ischemia. Minimal patchy periventricular white matter FLAIR hyperintensity compatible with chronic small vessel ischemic changes. Chronic left frontal lobe infarct with associated gliosis. No mass or edema is evident. The ventricles and basal cisterns are normal in size and configuration.MRA:Mild atherosclerotic irregularity of the cavernous segments of the internal carotid arteries. There is a broad-based 3 x 4 mm aneurysm arising inferomedially from the horizontal cavernous segment of the right internal carotid. There is a complete circle of Willis. The left A1 segment is hypoplastic. The right P-comm is hypoplastic. Partial fetal morphology left PCA. No high-grade stenoses.
1. Minimal small vessel ischemic changes and chronic left frontal lobe infarct. No acute ischemia.2. No high-grade steno-occlusive disease in the head. There is mild atherosclerotic irregularity of the cavernous segments of the internal carotid arteries.3. 3-4 mm broad-based saccular aneurysm arising from the horizontal right internal carotid artery cavernous segment.