Diagnosis: Other specified disorders of muscleClinical question: assess for new strokeSigns and Symptoms: right face/arm/leg numbness MRI of the brainNo diffusion weighted abnormalities are appreciated.Incidental note is made of a developmental venous anomaly in the right cerebellar hemisphere.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 mucosal thickening of the maxillary sinuses and left ethmoid air cells and opacification of the right frontal sinus. 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 large. The right A1 segment is hypoplastic. There is fetal origin of the right posterior cerebral artery associated with a relatively large right p1 segment. The left posterior communicating artery is small. The left vertebral artery is larger than the right vertebral artery.
1.No evidence for cerebrovascular occlusive disease.2.No evidence for intracranial aneurysm.3.No evidence for acute ischemic cerebral infarction.