Evaluate for etiology headaches, intractable : intractable migraine, right facial pain . Brain: There are multiple, at least 10, foci of T2 hyperintensity in the cerebral white matter, mainly in a periventricular distribution, without associated enhancement. There is no evidence of intracranial hemorrhage, mass, or acute infarct. 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, and paranasal sinuses are grossly unremarkable. Cervical Spine: The vertebral column alignment is straightened in the sagittal plane. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. There is no abnormal enhancement in the spine. There is a lipoma in the subcutaneous tissues of the right upper neck that measures up to 12 mm in thickness.
1. Multiple foci of T2 hyperintensity in the cerebral white matter are nonspecific, but may represent a demyelinating process, stigmata of migraines, or vasculitis, for example.2. No evidence of cervical spinal cord lesions. 