89 years Female (DOB:11/16/1926)Reason: eval for organic causes of seizure PROVIDER/ATTENDING NAME: TIEN S DONG EVAN H. LYON The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There are several punctate foci of susceptibility effect and subcortical white matter predominantly in the right hemisphere. Additional punctate foci of signal hypointensity on susceptibility imaging are identified in the cerebellum and left internal capsule.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Some scattered punctate foci of signal hyperintensity are present in the brainstem.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate partial opacification of the right maxillary sinus with a small air-fluid level. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Periventricular and subcortical white matter lesions of a moderate degree and a few punctate lesions in the brainstem are nonspecific. At this age they are most likely vascular related. 2.No evidence for acute cerebral ischemic infarction.3.No abnormal enhancing mass lesion is appreciated within the brain parenchyma to explain patient's seizures.4.Multiple microhemorrhages in the right hemispheric subcortical white matter and cerebellum are nonspecific in distribution.5.Examination is somewhat compromised due to patient motion artifact which may obscure more subtle abnormalities6.Opacification of the right maxillary sinus with a small air-fluid level is present most likely is inflammatory in nature. The possibility of a superimposed acute sinusitis cannot be excluded. Another possibility is that this represents retained secretions. Please correlate with clinical symptoms.