 MRI BRAIN: The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are mild bilateral punctate T2/FLAIR hyperintense foci within the periventricular and subcortical white matter as well as the pons most compatible with chronic small vessel ischemic disease. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. There are moderate secretions within the maxillary sinuses with air-fluid levels, right greater than left. The mastoid air cells are clear.MRI ORBITS: There is ectasia of the optic nerves and optic nerve root sheaths. The optic chiasm and optic tracts appear normal. There is flattening of the optic discs. The extraocular muscles are normal and symmetric. The globes appear normal. No retinal detachment or vitreous clouding. The lacrimal glands are symmetric and within normal limits for size. No orbital mass lesion. Note is made of a partially empty sella with CSF signal within the pituitary fossa.
1.Limited exam as only precontrast images were obtained due to patient intolerance.2.Partially empty sella with ectasia of the optic nerves and optic nerve root sheaths as well as flattening of the optic disks. This constellation of findings can be seen in idiopathic intracranial hypertension (aka pseudotumor cerebri) in the appropriate clinical setting.3.Chronic small vessel ischemic disease. 4.Bilateral maxillary sinus opacification with air-fluid levels, right greater than left, similar to recent CT.