New onset left hand tremors and subtle extrapyramidal signs. Evaluate for basal ganglia or intracranial lesions. There is no evidence of acute intracranial hemorrhage, or mass effect. Diffusion-weighted images are incomplete. No evidence of acute infarct of the imaged portion of the brain. There is no midline shift or mass effect. There are scattered punctate foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific but compatible with mild age-related white matter changes. There is prominent T2 hyperintensity with susceptibility involving the basal ganglia including the putamina and globi pallidi as well as the midbrain, and to a lesser degree deep nuclei of the cerebellum. Caudate nuclei appear normal in size with normal signal characteristics. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There is mild mucosal thickening throughout the paranasal sinuses as well as fluid level within the left maxillary sinus.
1.No intracranial mass or mass effect. No abnormal enhancement.2.Nonspecific prominent T2 hypointensity and susceptibility effect involving the bilateral basal ganglia and midbrain which may represent physiologic mineralization but raise possibility of conditions associated with NBIA (neurodegeneration with brain iron accumulation) in the appropriate clinical setting.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.