39 years Male (DOB:8/16/1977)Reason: h/o status epilepticus as a child, TBI, and HTN History: cognitive decline - global dysfunction (may have been longstanding)PROVIDER/ATTENDING NAME: JAMES A. MASTRIANNI JAMES A. MASTRIANNI The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a lesion present within the left frontal lobe subcortical white matter associated with susceptibility effect on inversion recovery imaging which appears to be heterogeneous on FLAIR and T2 imaging and does not enhance with contrast. It appears be slightly hypointense on T1There are a couple periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyes are have increased AP dimension and are associated with lumen of scleral thickening.The visualized upper cervical spine at C2-3 there is a disc bulge associated with effacement of spinal fluid ventral and posterior the spinal cord suggesting spinal stenosis.
1.A small chronic hemorrhagic lesion is present in the left frontal lobe superior frontal gyrus subcortical white matter. One possibility is it is related to prior injury.2.Findings raise the question of spinal stenosis in the upper cervical spine. Please correlate with clinical symptoms. If appropriate MRI of the cervical spine may be of further benefit in evaluating this.3.Staphylomas of the eyes.