Numbness and tingling of the right upper extremity with concern for demyelinating disease. There is no evidence of acute intracranial hemorrhage or mass effect. There is a punctate focus abnormal T2 hyperintensity within the white matter of the left inferior frontal lobe and left aspect of the cerebellar vermis, which are nonspecific. There diffusion hyperintensity associated with the left inferior frontal lobe T2 hyperintensity without clear low ADC values. There is an additional nonspecific left frontal lobe punctate T2 hyperintensity. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There is mild mucosal thickening of the left maxillary and right sphenoid sinuses.
Punctate T2 hyperintense foci within the white matter of the left inferior frontal lobe and left aspect of the cerebellar vermis, with mild restricted diffusion associated with the left inferior frontal lobe lesion. The left inferior frontal lobe lesion may represent an acute to subacute infarct versus an active demyelinating lesion which can also show restricted diffusion. Postcontrast sequence would be helpful, but were not be obtained due to inability of gaining intravenous access. Patient will reschedule for the postcontrast sequences. Please note however there is no specific evidence of chronic demyelinating disease on this study although remains a possibility. Further evaluation with CSF analysis may be helpful.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.