Altered mental status, unspecified [R41.82] / Other specified abnormal immunological findings in serum [R76.8], Reason for Study: ^Reason: 69yo with acute AMS w/+ANA, low complement. Concern for systemic autoimmune dz. Eval with MRI/MRA for comparison, Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion.Underlying brain shows diffuse minimal brain volume loss which is age appropriate.Multifocal scattered high signal intensities on periventricular white matter on T2-weighted imaging and FLAIR imaging indicate nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA:3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. Bilateral PCAs are fetal origin and the left distal vertebral artery is hypoplastic. The right MCA distal M1 shows subtle signal decrease on MIP reconstruction but does not show any significant luminal stenosis on source images.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Non specific small vessel ischemic disease.3. Normal brain MRA. 