Transient gait abnormality. Evaluate for metastasis or stroke. There is no acute infarct or intracranial hemorrhage. There is no mass-effect, midline shift or brain herniation. There is mild-to-moderate confluent T2-hyperintensity involving the periventricular frontoparietal white-matter. Scattered punctate T2-hyperintense lesions are present in both cerebral hemispheres as well. These, though nonspecific, are likely related to microvascular ischemia. The ventricles are enlarged and so are the other CSF-containing spaces and basal cisterns. The volume loss is more pronounced in the parietal lobes. There is focal expansion of a left parietal sulcus with suggestion of peripheral displacement of the traversing vessels. While this may still relate to underlying volume loss, as small arachnoid cyst can also give a similar appearance. There is no abnormal brain or leptomeningeal contrast enhancement.There has been left eye lens replacement. The orbits are otherwise grossly unremarkable. There is no skull destructive lesion.
1. There is no brain or leptomeningeal abnormal contrast enhancement to indicate metastasis.2. Mild-to-moderate cerebral white-matter T2-hyperintense lesions are nonspecific but likely reflect chronic microvascular ischemia. 3. There is also mild brain volume loss, most pronounced in the parietal lobes. Focal expansion of a left parietal sulcus with suggestion of displacement of the traversing vessels may still relate to underlying volume loss but a small arachnoid cyst can result in a similar appearance. 