Reason: Evaluate for aneurysm or vascular abnormality and etiology of SAH History: SAH, ICH, seizures. MRI of the brainNo diffusion weighted abnormalities are appreciated.There a multiple punctate foci of signal loss on susceptibility imaging in the deep gray nuclei and to a lesser degree subcortical white matter and in the right cerebellar hemisphere and brainstemThere is a hemorrhagic lesion in the right frontal subcortical white matter.There is subarachnoid susceptibility effect along the ambient and quadrigeminal plate cisterns.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 demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.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.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is medium sized. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.No evidence for cerebrovascular occlusive disease.2.No evidence for intracranial aneurysm.3.Subarachnoid blood in the ambient and quadrigeminal plate cisterns4.Small right frontal hematoma5.Multiple microhemorrhages are present throughout in the deep gray nuclei, cerebellum and subcortical white matter. The pattern is suggestive of hypertension.6.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 7.The exam is degraded due to patient motion. This may obscure more subtle abnormalities.