Clinical question: Headache. Signs and symptoms: Headache. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination demonstrates few punctate foci of FLAIR hyperintensity primarily in the subcortical white matter of bilateral frontal lobes without evidence of hemorrhagic changes or enhancement. Findings are nonspecific however considering patient's stated age possibility of demyelinating disease or small vessel ischemic stroke to be considered.The anatomical morphology and the signal intensity of brain parenchyma is otherwise within normal on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.There is no detectable abnormal enhancement of brain parenchyma or the leptomeninges.Unremarkable images through the orbits and including axial fat sat post enhanced series.Calvarium and soft tissues of the scalp demonstrate normal signal intensity and without abnormal enhancement.Paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
1.Negative diffusion weighted images.2.Few punctate nonspecific foci of FLAIR hyperintensity only in the subcortical white matter of frontal lobes as detailed.3.Unremarkable pre and post enhancement brain MRI otherwise as detailed above.4.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells.