 There is no suspicious intracranial enhancement, acute infarct, mass effect or midline shift. There are numerous nonspecific periventricular and subcortical punctate white matter T2 signal abnormalities with additional lesions in the right thalamus and questionable ill-defined foci in the central pons (series 501 image 6). There is no suspicious enhancement of the cisternal portions of the trigeminal nerves. Incidental note is made of a small focus of enhancement in the fundus of the left and auditory canal which measures partially 4 x 5 mm in greatest axial dimensions at 1801/47.There is minimal scattered ethmoid sinus mucosal thickening.
1. No acute intracranial abnormality. 2. Small enhancing nodule in the left internal auditory canal fundus, which could represent a small vestibular schwannoma. Dedicated MRI of the internal auditory canals could be obtained for more detailed evaluation, and clinical correlation is recommended. No definite abnormality involving Meckel's caves, although dedicated trigeminal protocol was not obtained.3. Multiple nonspecific nonenhancing white matter lesions, with differential diagnosis including infectious and inflammatory processes, demyelinating disease, chronic small vessel ischemic changes.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.