Reason: compare aneurysm History: TIA MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The left eyeball lens is thin.Incidental note is also made of congenital fusion of C2 on C3.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.No intracranial stenosis is appreciated. There is a 2.8 x 2 mm right communicating segment aneurysm present which is directed laterally and anteriorly. This is stable compared to the September exam. There is a 3 mm x 2.5 mm left posterior communicating artery aneurysm present. This is stable compared to the September exam. The origin of the left posterior communicating artery comes off the base of the aneurysm along its medial aspect. There is a 2.5mm infundibulum at the origin of the right PCOMA. There is an extracranial origin of the right posterior inferior cerebellar artery.The anterior communicating artery is a small to medium-sized and the posterior communicating arteries are identified and are small but are intact.
1.Findings indicate small bilateral communicating segment aneurysms. These are stable since 1/31/13.2.No evidence for acute ischemic cerebral infarction.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 