Dysarthria and dysphagia. A few T2-hyperintense subcortical lesions in the frontal white-matter have minimally increased since the January 2013 examination. The brain parenchyma and pituitary gland appear unremarkable otherwise. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and sulci are unchanged. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the ethmoid sinuses. There are degenerative changes involving the right temporomandibular joint, with associated enhancement.
1.A few nonspecific frontal white-matter lesions have minimally increased since January 2013 and may represent chronic microvascular ischemia, among other potential etiologies.2.No evidence of intracranial hemorrhage, mass, or acute infarct.3.Degenerative changes involving the right temporomandibular joint with apparent associated inflammation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.