No suspicious calvarial lesions are identified. Bony orbits and their contents are symmetric and intact.
ANGIOGRAM: No significant atherosclerotic disease is identified in the head or neck.
There is three vessel aortic arch anatomy. The origins of the great vessels are patent.
The cervical segments of the carotid arteries are normal in course and caliber. No stenosis is noted at the carotid bifurcations.
Petrous, cavernous, and supraclinoid segments of bilateral internal carotid arteries are patent and normal in course and caliber. The branches of bilateral middle cerebral and anterior cerebral arteries are patent. The ophthalmic arteries are identified.
Bilateral vertebral arteries arise from the subclavian arteries. Their patent cervical segments enter the foramen transversarium at normal mid cervical levels. The distal intracranial segments of the vertebral arteries are patent, with normal C1/C2 loops. The basilar
artery is patent and normal in caliber, giving rise to patent bilateral superior cerebellar arteries and posterior cerebral arteries.
POST CONTRAST HEAD: There are no areas of abnormal intracranial enhancement.
POST CONTRAST NECK: The remainder of the soft tissues of the neck appear unremarkable. Heterogeneity of the right upper lobe pulmonary vessels. Multilevel degenerative changes of the cervical spine are
appreciated. There are no other osseous lesions.
1. Multiple prominent serpiginous vessels centered around the superior sagittal sinus in the region of the torcula, left temporal, and left occipital regions associated with dural venous sinus prominence and occipital extracranial arterial vessels. Overall, findings are consistent with a high-risk dural AV fistula.
2. Filling defect in the left transverse and sigmoid sinus corresponding with hyperdensity on noncontrast images, consistent with venous sinus thrombosis.
3. Subarachnoid hemorrhage along the left temporal lobe.
4. Heterogeneity of the right upper lobe pulmonary vasculature. This could be due to technique and this exam is not designed to evaluate for pulmonary embolus. If clinically concerned for pulmonary embolus, a dedicated chest CTA can be obtained.