 MRI brain:There are punctate T2/FLAIR hyperintense foci in the subcortical bilateral frontal and anterior parietal white matter without associated diffusion restriction, susceptibility artifact, or pathologic enhancement. There are no similar lesions in the posterior fossa. Incidental note is made of congenital hippocampal sulcus remnants bilaterally of no clinical significance. The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Right maxillary sinus retention cyst.MRI cervical spine:The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. There is no pathological enhancement.At C2-C3, there is no significant spinal canal or neuroforaminal stenosis.At C3-C4, there is no significant spinal canal or neuroforaminal stenosis.At C4-C5, there is small left paramedian disc protrusion. There is no significant spinal canal or neuroforaminal stenosis.At C5-C6, there is no significant spinal canal or neuroforaminal stenosis.At C6-C7, there is annular tear and small left paramedian disc protrusion. There is no significant spinal canal or neuroforaminal stenosis.At C7-T1, there is no significant spinal canal or neuroforaminal stenosis.
1.Punctate subcortical T2/FLAIR hyperintense foci in the bilateral frontal and anterior parietal lobes. Differential diagnosis would most likely include small vessel ischemic disease, migraine sequelae, or residua from remote head trauma. Given lesion location and morphology, demyelinating disease is considered unlikely.2.Two small cervical spine disc herniations without significant mass effect or resulting stenosis.