53 year old female with episodic hypertension, evaluate for intracranial or posterior fossa tumor The ventricles, sulci and cisterns are symmetric and unremarkable. There are a few scattered periventricular and subcortical foci of T2 signal abnormality within the white matter, sparing the posterior fossa, without associated mass effect, restricted diffusion, or susceptibility abnormality. The gray-white matter differentiation is normal. There is no mass, midline shift, intra or extra-axial fluid collection/hemorrhage, or evidence of acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. Small right ethmoidal sinus retention cyst or polyp. Fluid within a few right mastoid air cells. The paranasal sinuses and mastoid air cells are otherwise clear.
Few There are a few scattered periventricular and subcortical foci of T2 signal abnormality within the white matter, sparing the posterior fossa, without associated mass effect, restricted diffusion, or susceptibility abnormality. These are nonspecific in appearance, and the differential diagnosis would most likely include small vessel ischemic disease, migraine sequelae, or the residua of prior head trauma. Given their morphology and location, demyelinating disease is considered unlikely.