Interpreting MRA results

[sunflower822]

For the past 4 years, I have been having the following symptoms: lightheadedness/groggy feeling, pressure in my forehead, between my eyes, and nose. Sometimes I have one or the other problem and other times I can have both....In the past, they occurred very infrequent so I didn't really think too much about it.  Over the past 3 months, my symptoms have occurred weekly.  I usually take 2 Advil but it does not make my symptoms fully go away.  

3 weeks ago I had a MRI and MRA scan. At first, my doctor thought my frontal headaches were had to do with my allergies (allergy sufferer since I was very young...I now get shots monthly).  My MRI came back normal but it did show a small (which I thought looked very big) intention cyst on the right maxillary sinus. All other sinuses looked clear.  

My MRA results showed the following:

Diffusely small caliber of the basilar artery with greater narrowing at the middle third with suggestion of slight post stenotic dilatation. The finding is associated with prominent fetal type origins of the posterior cerebral arteries, and it is a finding consistent with a developmental or congenital anatomic variation. The degree of narrowing of the middle third of the basilar artery is quite significant and there is a suggestion of post stenotic dilation distal to their segment of narrowing.

Superimposed narrowing secondary to related to vasospasm, posterior circulation migraine headaches or cerebral vasculitis cannot be excluded on the basis of the MRI examination only.

I have an appt. with a neurologist on Wednesday.  Any thoughts?

[GingerNc]

Have had several tests, MRA, MRI, spinal tap, etc.  Eyes have suddenly turned inward.

Any help explaining these results....

MRA.
demonstrated fenestrated basilar in its mid portions
  alsoredundancy within the internal carotid arteries and the vertebrobasilar system
there is no discrete aneurysm orvascular malformation noted
MRI.
demonstrated muliple white matter signal abnormalities

Any responses are greatly appreciated.

[sunflower822]

Thanks for your response.

I am a healthy 27 year old female.

My doctor reviewed my films with another doctor and the radiologist that did the analysis.  They beleive that I was born with the small vessels in the back of my head and that it isn't uncommon. He said that they do not need to be that big because they do not supply a big area of the brain.   He said that the basilar artery showed narrowing and he would like to do the CT-scan to get a better understanding of the narrowing. He put me on 1 asprine a day.  He said that my symptoms are not related to this problem. So, the question still remains....why do I sometimes feel funny/off/lightheaded......and pressure in my forehead/nose/between my eyes?  I'll keep you posted.  

[CCF-Neuro-M.D.-PW]

The fetal origin of the posterior cerebral artery is a normal variation and usually is nothing to worry about. The basilar artery finding is more difficult to interpret. Together with the fetal origin of the PCA it may just all be developmental and is probably not causing your symptoms - I have not seen your scan so I cannot confirm this.

I don't know how old you are, of old the liklie hood of a problem with the artery is greater ie atherosclerosis

The MRA has to be interpreted with caution though as it can over estimate narrowings in vessels because of the nature of teh magnetic signal used to create the scan. Anything but a severe narrowing may not even cause any symptoms at all. If there remains a question about the basilar artery, an dye angiogram could make things clearer/define the real extent of the narrowing and the rest of your vascular anatomy.

Good luck