History of chronic suppurative otitis media now with dizziness and headaches in the setting of possible chronic Lyme disease. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a right temporal lobe developmental venous anomaly. The brain parenchyma otherwise appears unremarkable. 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.Internal Auditory Canals: There is mild high T2 signal in the right mastoid air cells region. The bilateral cranial nerve 7 and 8 complexes are intact. There is no evidence of mass lesions. The inner ear structures, including the cochlea, vestibule, endolymphatic duct, and semicircular canals, appear unremarkable.
1. Mild scattered foci of T2 hyperintensity in the right mastoid air cells, which may represent a sequela of prior infection. However, assessment of the middle ear is limited on MRI and a temporal bone CT may be useful for further evaluation.2. Right temporal lobe developmental venous anomaly.