74 years Female (DOB:9/1/1941)Reason: evaluate for ischemic infract, mass History: AMSPROVIDER/ATTENDING NAME: CHRISTOPHER L KRAMER CHRISTOPHER L KRAMER MRI of the brainNo diffusion weighted abnormalities are appreciated.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.There is encephalomalacia involving the left temporal lobe along the fusiform gyrus and parahippocampal gyrus which extends towards the lingual gyrus.The CSF spaces are appropriate for the patient's stated age with no midline shift. 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 some 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 a 3.5 mm protrusion of the posterior bend of the left internal carotid artery cavernous segment.There is no evidence for cerebrovascular occlusion. There is some mild narrowing at the distal right M1 segment.The anterior communicating artery is identified and is small. The left A1 segment is larger than the right A1 segment. The posterior communicating arteries are small. The left vertebral artery is significantly smaller than the right vertebral artery. The left middle cerebral artery has a proximal m1 bifurcation. The right middle cerebral artery has a distal m1 bifurcation.
1.No evidence for intracranial cerebrovascular occlusive disease.2.There is encephalomalacia involving the left temporal lobe centered at the fusiform and lingual gyri.3.There is a small aneurysm along the posterior bend of the left internal carotid artery cavernous segment.4.Periventricular and subcortical white matter lesions of a moderate degree are nonspecific. At this age they are most likely vascular related. 5.Exam is somewhat limited due to the patient's inability to cooperate as detailed by the technologist performing the exam.