known left thalamic and basal ganglia ICH with mass effects. There is 47mm x 57mm sized left thalamic and basal ganglia ICH with surrounding edema and midline shift toward right side.As well, IVH and right hemispheric SAH were also seen.Comparing to prior CT scan, the approximate size of the ICH, the degree of midline shift toward right side, and the extent of the IVH do not show any significant interval change.There is no evidence of acute ischemic lesion on this scan.Brain edema was also seen on the left cerebral peduncle, midbrain and upper pons area.The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal flow enhancement in bilateral distal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Acom artery is patent and bilateral Pcom arteries are also patent.There is no evidence of intracranial arterial aneurysm or significant luminal stenosis or occlusion.3D MRA neck non-gadolinium enhanced MRA with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in bilateral CCAs, extracranial ICAs and VAs.Aortic arch origins of major vessels cannot be precisely evaluated but appear to be within normal limits. Extracranial cranio-cervical arterial system appear to be normal without evidence of luminal irregularity or stenosis.
1. Re-demonstration of left thalamic and Basal ganglia ICH with mass effects as well as IVH and SAH.2. No evidence of acute ischemic lesion on this scan.3. No evidence of intracranial arterial aneurysm, significant luminal stenosis or occlusion.4. No evidence of extracranial cranio cervical arterial system's significant luminal stenosis or occlusion . 