 MRI BRAIN: No restricted diffusion to suggest acute ischemia in the brain. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Bone marrow signal and extracranial soft tissues are within normal limits. Partially empty sella, which may be a normal variant.MRI ORBITS: The right maxillary sinus is small which may related to hypoplasia or atelectasis from prior chronic sinus disease. There appears to be minimal mucosal thickening. There is no enophthalmos or significant downward displacement of right intraorbital contents. No abnormal mass or abnormal enhancement is seen in the orbits. The optic nerves are normal in size and signal intensity, and are symmetric bilaterally. No retrobulbar mass, chiasmatic mass, or parasellar abnormality is seen. Extraocular muscles are unremarkable.
1. Minimal chronic small vessel ischemic changes in the brain, which is otherwise unremarkable for age.2. No abnormal signal in the optic nerves or chiasm. 3. Small right maxillary sinus which may be related to atelectasis from prior chronic sinusitis versus hypoplasia. No additional imaging findings to suggest silent sinus syndrome. CT can better assess bony anatomy if clinically warranted.