Dissection of carotid artery [I77.71], Reason for Study: ^Reason: bilateral carotid dissection yearly follow up, h/ort hemispheric stroke 2013 History: stabile, yearly follow up. Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on this scan.Focal encephalomalacia on the right insular posterior aspect and posterior right parietal operculum appear to be stable.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. 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 normal ICAs, MCAs and ACAs. Right ACA A1 segment is hypoplastic. Vertebrobasilar system appears to be normal. Neck MRA3D MRA neck pre and post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate irregularities of the right extracranial ICA cervical segment and proximal petrous segment without evidence of luminal narrowing.Otherwise normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, and left internal carotid, and vertebral arteries.
1. No change of right extracranial ICA luminal irregularity since prior scan. Otherwise unremarkable Neck MRA.2. No change of chronic ischemic stroke on the right posterior insular and posterior aspect of right parietal operculum.3. No evidence of acute ischemic or hemorrhagic lesion.4. Normal brain MRA. 