 Brain MRI: The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Note is made of a probable developmental venous anomaly anterior to the cingulate sulcus on the left side.Head MRA: The intracranial internal carotid arteries are normal in course and caliber. The right A1 segment is hypoplastic. There is a 2 mm aneurysm at the junction of the left anterior cerebral artery and anterior communicating artery directed posteriorly and medially. No other definite aneurysm is identified.There is fetal supply of the right PCA. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course. There is no evidence of flow-limiting stenosis or additional aneurysm. The left vertebral artery is hypoplastic and terminates as the PICA. The right vertebral artery continues on as the basilar artery.Neck MRA: There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber, without evidence of stenosis or occlusion.Both vertebral artery origins are patent. The right vertebral artery is dominant. There is no evidence of stenosis or occlusion.
1. 2 mm aneurysm at the junction of the left anterior cerebral artery and anterior communicating artery. No other definite aneurysm is identified.2. No evidence of acute intracranial hemorrhage.