CT and CTA brain
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Sliver of high attenuation material within the dependent portion of the left circular sulcus likely represents a small amount of subarachnoid blood. No other intracranial haemorrhage identified.
Hyperdensity seen within the suprasellar cistern corresponds to the large left terminal MCA aneurysm described below.
Bilateral periventricular and deep white matter hypoattenuation is likely in keeping with chronic small vessel ischaemia. Large calcified pineal gland. Ventricles and sulcal pattern are age appropriate.
The left common carotid artery arises from the brachiocephalic trunk. The left vertebral artery arises directly from the aortic arch, between the origins of the brachiocephalic trunk and left subclavian artery. Right dominant vertebral artery. Tortuous bilateral common carotid arteries near their origins.
There is a large, lobulated, anteriorly directed 11 x 4 x 14 mm aneurysm arising from the terminal left ICA, with a 3 mm neck. Further 2 mm aneurysm at the right M1 bifurcation. Left PCOM infundibulum.