 There is no evidence of intracranial hemorrhage or acute infarct. There appears to be patchy high signal on the thin-section postcontrast T1 images along the right internal auditory canal. There are also minimal scattered punctate foci of T2 hyperintensity within the cerebral white matter. The brain, brainstem, and cerebellar parenchyma otherwise appear unremarkable. 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.Apparent patchy high signal on the thin-section postcontrast T1 images along the right internal auditory canal may be artifactual, vascular, inflammatory, or represent leptomeningeal metastatic disease. Follow up via a temporal bone MRI may be useful if there is clinical concern. Otherwise, no evidence of intra-axial metastases.2.Punctate foci of T2 hyperintensity in the cerebral white matter are nonspecific, but may represent chronic microvascular ischemic disease. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.