Male, 22 years old, with numbness, twitching limbs, speech difficulty, and headache. A 7 mm, relatively round T2 hyperintense lesion is evident within the left frontal white matter showing no evidence of associated mass effect, restricted diffusion or susceptibility artifact. A much smaller T2 hyperintense lesion is evident within the right periatrial white matterMild CSF prominence at the level of the right choroidal fissure is seen. Brain parenchymal morphology is otherwise within normal limits. No evidence of significant edema or mass effect is detected. No restricted diffusion is seen. No evidence of intracranial hemorrhage is detected. The ventricular system is within normal limits for size.
1.Two subcentimeter white matter lesions are identified, one within the left frontal lobe and one in the right periatrial region. Although these are not adequately specific to make a definitive diagnosis, the possibility of a demyelinating process should be considered. Imaging follow-up with contrast may be considered as clinically warranted.2.Mild CSF prominence at the level of the right choroidal fissure may represent an anatomic variation or a small choroidal fissure cyst, in any case likely an incidental finding.