Vertigo. Brain: There are multiple scattered cerebral white-matter lesions that are most pronounced in the frontoparietal lobes. None of the lesions shows abnormal contrast enhancement. Compared to the previous examinations, there is no new or growing lesion. The lesions are more visually more conspicuous on today's examination but this may relate to technical factors.There continues to be no corpus callosal lesion. The corpus callosal volume is preserved. A small right dorsal pontine lesion is present. There is no significant involvement of the posterior fossa, otherwise.The small medial left middle cranial fossa arachnoid cyst is unchanged. Mild expansion of the ventricles and to lesser extend the sulci has not changed since the previous examination and probably reflects loss.The mastoid cells and the paranasal sinuses are clear. There is no gross orbital abnormality.Internal Carotid Canal:Internal artery canals are symmetric and normal. There is no abnormal signal or enhancement along the cisternal and canalicular segments of the seventh/eighth cranial nerve complexes. The inner ear structures are symmetric and show no abnormal contrast enhancement. The mastoid air cells are clear as well as the middle ear cavities. There is no destructive petrous lesion.Cervical Spine:Alignment is anatomic. The vertebral bodies are preserved in height and marrow signal. The intervertebral discs are also unremarkable. There is no central spinal canal or foraminal stenosis.The cervical spinal cord shows normal morphology and signal. There is no abnormal spinal cord or leptomeningeal contrast enhancement.There is a partially imaged 2 cm left thyroid lobe nodule. This was present on the previous neck ultrasound examination of January 21, 2013. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Brain: Numerous cerebral white-matter lesions without contrast enhancement are not significantly changed since the August 2015 MRI. The lesions do not show typical or specific features of multiple sclerosis, but an atypical demyelinating process may still be considered. Other etiologies including postinfectious and inflammatory phenomena would also be in the differential.2.IAC-CPA: No significant abnormality along the seventh/eighth cranial nerves or in the inner ear structures. There is a punctate T2-hyperintensity in the dorsal pons which has not changed since the previous examination. Otherwise, the brainstem is normal.3.Cervical spine: Normal. A left thyroid nodule is only partly visualized.