 MRI brain: Again seen is a stable pineal gland cyst which measures 12 x 10 mm, previously 12 x 10 mm. There are a few punctate foci of susceptibility effect in the cerebral hemispheres, unchanged. There is a single very small focus of T2 signal abnormality in the right frontal white matter, unchanged and nonspecific. There is no diffusion abnormality. There are no areas of abnormal signal or pathological enhancement.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. MRA brain: The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. Bilateral posterior communicating arteries are seen. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.
1. Stable pineal gland cyst. No new findings on brain MRI to account for patient's symptoms.2. No evidence of cerebrovascular occlusion or aneurysm.