Migraines, NF1, moya moya. MRI: There is an unchanged nonenhancing T2 hyperintense lesion within the periventricular white matter adjacent the left trigone that measures up to 10 mm. There is persistent slight intrinsic T1 hyperintensity within the bilateral globi pallidi and cerebral peduncles. There is a 10 mm wide arachnoid cyst medial to the posterior left cerebellar hemisphere. There is no evidence of intracranial mass, hemorrhage, hydrocephalus or acute infarct. There is a small right maxillary sinus retention cyst.MRA: There are persistent asymmetrically prominent right lenticulostriate vessels and paucity of flow related enhancement beyond the proximal portion of the superior division of the M2 segment of the right MCA, indicating a significant steno-occlusive lesion. There is no significant steno-occlusive disease involving the other major cerebral arteries. There is no evidence of aneurysm.
1. Unchanged intracranial stigmata of neurofibromatosis type 1, including what likely represents an "unidentified bright object" in the left periatrial white matter. 2. Mild asymmetrically prominent right lenticulostriate vessels suggestive of mild moyamoya associated with steno-occlusive disease of the superior division of the M2 segment of the right MCA.3. No evidence of acute cerebral infarction. 