Congenital anomaly of cerebrovascular system [747.81], Reason for Study: ^Reason: s/p embolization of vertebrobasilar aneurysm repair History: post-procedure follow up Brain MRIThere is no evidence of new acute ischemic or hemorrhagic lesion on this scan.There is large multi-stage blood clots within previously known basilar aneurysm sac which displaces remained basilar artery toward right side. The largest dimension of the lesion on coronal plane was about 33.1mm x 42.8mm which does not show any significant interval change since prior scan.There is no evidence of surrounding edema.Ventricle size appears to be stable since prior scan.Multiple small high signal intensity lesions on bilateral superior frontal gyri white matter and right external capsule on FLAIR images do not show any interval change since prior scan.The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate patent basilar artery with susceptibility artifacts on the wall where stents were deployed. Comparing to prior scan, the luminal diameter of the stented portion appears to be stable measured about 2.8mm.There is about 6.5mm sized high signal intensity pocket slightly inferior aspect of the parent artery which might have a small communication with parent artery lumen(series 301, image#43/152). Since the lesion's signal intensity appears to be slightly higher than adjacent basilar artery, this could represent paramagnetic artifacts from both stent and inserted detachable coils. Again, the possibility of small residual or recanalization of the aneurysm cannot be completely excluded.Previously measured 2mm sized high signal intensity pocket which is located at superior aspect of the parent artery appears to be stable in size and configuration since prior scan.Visualized bilateral ICA appears to be normal and known left extracranial ICA aneurysm was not included in this scan.
1. Post endovascular treatment (stent assisted coiling and sacrifice of the left distal vertebral artery) follow up scan shows no change of the size of thrombosing aneurysm without evidence of surrounding edema or increased mass effects.2. Ventricle size remains stable.3. Stented basilar artery lumen is patent and stable in diameter since prior scan.4. Suspicious recanalization or residual aneurysm pockets described above appear to be stable since prior scan. 