 MRI BRAIN: The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with marked chronic small vessel ischemic changes. There is no diffusion abnormality. No extra-axial fluid collection is identified. The midline structures and craniocervical junction are within normal limits.MRA HEAD: There is a 3.1 mm aneurysm projecting off the A2 segment of the right ACA and is directed towards the left. The distal right vertebral artery is hypoplastic and terminates into the right PICA. There is is otherwise dolichoectasia of the vertebrobasilar system. The left PCOM is small is size. The intracranial internal carotid arteries are normal in course and caliber. The middle, anterior and posterior cerebral arteries are otherwise unremarkable. There is no evidence of flow-limiting stenosis.
1. periventricular white matter changes are present which are nonspecific and are more than expected at this age. Etiology is uncertain.2. 3 mm right A2 aneurysm projecting towards the left. 3. No evidence for intracranial cerebrovascular stenosis.