CT head 9/10/2015 and 9/10/2013. MRA BRAIN: There is a saccular aneurysm arising from the anterior communicating artery that is inferiorly-directed and measures 9 mm in length, 7 mm in width, and a neck that measures approximately 5 mm in width. There appears to be mild mass-effect upon the prechiasmatic optic nerves. There is no evidence of significant steno-occlusive lesions. The left vertebral artery terminates are the PICA, which is an anatomic variant.MRI BRAIN: There is no evidence of intracranial hemorrhage or acute infarct. There are scattered subcortical and confluent periventricular hyperintensities, which may be nonspecific most likely related to chronic small vessel ischemic changes. The ventricles are unchanged. There is no midline shift or herniation. There are left orbital floor fracture and lamina papyracea blow out fractures associated with enophthalmos. The left maxillary sinus contains mucosal thickening and is smaller in size compared to the right. There is torus palatinus. There is a large lipoma overlying the right occipital scalp, grossly unchanged from previous.
1. A saccular aneurysm arising from the anterior communicating artery measures up to 9 mm.2. No evidence of acute intracranial hemorrhage or acute infarct.3. Moderate periventricular white matter hyperintensities likely related to chronic small vessel ischemic disease.4. Chronic eft orbital floor fracture and lamina papyracea blow out fractures associated with enophthalmos.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.