Left Bells palsy, not improving after 4 weeks. Internal Auditory Canals: There is diffuse enhancement along the left facial nerve, including cisternal, labyrinthine, tympanic, mastoid, and parotid segments. The right cranial nerve 7 and 8 complex is intact. There is no evidence of mass lesions. The inner ear structures, including the cochlea, vestibule, endolymphatic duct, and semicircular canals, appear unremarkable. The bilateral mastoid air cells and middle ears also appear unremarkable.Brain: There are unchanged areas of encephalomalacia in the right parietal and left temporal lobes, as well as in the left cerebellum. There are also multiple foci of T2 hyperintensity in the subcortical and periventricular white matter, which are also unchanged. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Diffuse enhancement along the left facial nerve may represent an inflammatory neuritis. Otherwise, no evidence of mass lesions.2. Unchanged areas of encephalomalacia in the right parietal and left temporal lobes, as well as in the left cerebellum superimposed upon a background of probable chronic small vessel ischemic disease, but no evidence of acute infarction.