 Brain: No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, primarily in the frontal lobes, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Cerebellar tonsils are borderline low with preserved normal rounded morphology. Brain parenchyma is otherwise unremarkable for age. No abnormal parenchymal or meningeal enhancement. Specifically no lesions are seen along the courses of the cranial nerves, cavernous sinuses, or orbital apex. Major flow-voids are preserved.Sella is grossly within normal limits. Mild mucosal thickening involving the right maxillary sinus. Mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. Small skin nodule is seen at the right cheek which can be better assessed on examination.Orbits: No abnormal mass or abnormal enhancement is seen. No abnormal signal intensity is evident. The optic nerves are normal in size and signal intensity, and are symmetric bilaterally. No retrobulbar mass, chiasmatic mass, or parasellar abnormality is seen. Extraocular muscles are unremarkable.
1. Brain MRI is essentially unremarkable for age. There are scattered foci of T2/FLAIR hyperintensity in the supratentorial white matter which are nonspecific but compatible with mild chronic small vessel ischemic changes.2. Orbit MRI is within normal limits.3. Mild right maxillary sinus mucosal thickening.