88 year-old male with AMS following a syncopal episode. Evaluate for ischemic event. MRI Brain:Images are limited by patient motion. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a mild to moderate degree of periventricular and subcortical white matter T2/FLAIR hyperintensity consistent with moderate chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration for age. There is no midline shift or herniation. The major cerebral flow voids are intact. There is incidental empty sella.MRA Brain: There is mild irregularity and atherosclerotic disease of the right intracranial ICA. The left ICA is patent. The bilateral ACA and MCA are patent. Irregularity and moderate atherosclerotic narrowing of the proximal to mid right V4 segment likely secondary to atherosclerotic disease. There is a small right posterior communicating artery. The basilar artery and left vertebral artery are patent. Posterior cerebral arteries are unremarkable.
1.No evidence of acute ischemia.2.Mild to moderate chronic small vessel ischemic disease.3.Moderate narrowing of the proximal to mid right V4 segment.