16 year old male with sickle cell disease, evaluate for stenosis or Moya Moya. There is no evidence of intracranial mass, hemorrhage or infarction. No parenchymal signal abnormality is identified. There is no restricted diffusion or enhancing abnormality. The ventricles are normal in size and shape. Diffuse mucosal thickening is seen in the paranasal sinuses and right mastoid air cells.Perfusion post processing on an independent workstation demonstrate no significant perfusion defects.MR angiography demonstrates a right periophthalmic saccular aneurysm along the lateral aspect of the cavernous carotid measuring approximately 4 x 4 mm and directed laterally. There is a suggestion of a tiny outpouching on the medial aspect of the preophthalmic left cavernous carotid. Neither of these aneurysms were evident on the comparison study, although it was performed at 1.5 Tesla and was motion degraded. Otherwise the remaining anterior, middle and posterior cerebral arteries are unremarkable without hemodynamically significant stenosis.
Negative brain MRI without evidence of ischemia or perfusion defect.1.MR angiography demonstrates a right periophthalmic saccular aneurysm along the lateral aspect of the cavernous carotid measuring approximately 4 x 4 mm and directed laterally. There is a suggestion of a tiny outpouching on the medial aspect of the preophthalmic left cavernous carotid. Neither of these aneurysms were evident on the comparison study, although it was performed at 1.5 Tesla and was motion degraded.2.Attempts to discuss findings with the ordering provider on the day of image acquisition (1/24/2015) were unsuccessful. Given the findings are not urgent or emergent, another attempt will be made on Monday 1/26/2015.