69 years Male (DOB:3/21/1947)Reason: evaluate for structural brain lesion History: hx dysphagiaPROVIDER/ATTENDING NAME: NITASHA SARSWAT NITASHA SARSWAT The CSF spaces are appropriate for the patient's stated age with no midline shift. There are punctate foci of signal loss and susceptibility weighted imaging along the subcortical white matter of the supratentorial brain as well as in the cerebellum. There is a larger cassette signal loss and susceptibility in the left cerebellar hemisphere and also be identified on the T2 and FLAIR images is signal loss. There is a punctate focus of signal loss on susceptibility weighted imaging in the lower brainstem as well.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially.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 are clear. 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 mild degree are nonspecific. At this age they are most likely vascular related. 2.Multiple microhemorrhages are present in the brain whose pattern is rather mixed in the etiology is uncertain. Subcortical microhemorrhages are known to be associated with amyloid angiopathy, however, this is nonspecific. There are also a few cerebellar microhemorrhages present as well one in the loser brainstem which can be seen with hypertensive type hemorrhage among other causes.