Dizziness and giddiness [R42], Reason for Study: ^Reason: 67 yo M with new onset vertigo and nystagmus vs occular flutter, ?cerebellar lesion History: nystagmus vs. occular flutter, vertigo Bilateral lateral ventricles, third ventricle are enlarged with a subtle FLAIR/T2 high signal intensity seen on bilateral periventricular white matter especially occipital horn area and artifact which are non specific but could be related to ventricular enlargement. There is no evidence of occlusive lesion in CSF pathway.There is no evidence of acute ischemic or hemorrhagic lesion on scan.About 7 mm downward displacement of bilateral cerebellar tonsils through the foramen magnum.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Right maxillary sinus retention cyst.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.
1. Ventriculomegaly involving bilateral lateral ventricles and 3rd ventricle without evidence of occlusive lesion within CSF pathway.2. No evidence of acute ischemic or hemorrhagic lesion.3. Normal brain MRA.