 Orbits: No abnormal signal is seen within the optic nerves. No intraorbital mass or abnormal enhancement is appreciated. Extraocular muscles and globes are grossly unremarkable. Brain: Chronic infarct is evident involving the right basal ganglia, anterior limb of the internal capsule, and the right frontal corona radiata. There are scattered nonspecific T2/FLAIR hyperintensities in the periventricular and subcortical white matter, which are nonspecific but likely represent chronic small vessel ischemic disease. There are however multiple T2/FLAIR hyperintense lesions adjacent to the bilateral temporal horns as well as in the right temporal subcortical white matter which are unusual for small vessel ischemic disease. Ventricular size is normal with no midline shift. The basal cisterns are patent with no herniation. There is no restricted diffusion. There are linear susceptibility signal in the basal ganglia bilaterally, most likely representing blood products from previous hemorrhage. There is no acute hemorrhage. No evidence of mass effect. The postcontrast images degraded by motion however, there is no appreciable abnormal enhancement.Small ovoid lesions involving the bilateral parotid glands which probably represent small lymph nodes. There is fluid in the bilateral mastoid air cells. Calvarium and extracranial soft tissues are otherwise unremarkable.
1. No abnormal signal is seen involving the optic nerves. Bilateral orbits appear within normal limits.2. MRI of the brain demonstrates evidence of chronic small vessel ischemic disease including a chronic infarct involving the right frontal corona radiata, basal ganglia, and anterior limb of the internal capsule.3. There are multiple T2/FLAIR hyperintense lesions adjacent to the bilateral temporal horns as well as in the right temporal subcortical white matter which are unusual for small vessel ischemic disease. As such, other etiologies such as demyelinating disease and inflammatory processes should be considered. No abnormal enhancement to suggest an active demyelination/active inflammation.