Left vocal cord paralysis, elevation of the left hemidiaphragm. History of polymyositis.. Brain: Brain parenchyma appears within normal limits for age. No intracranial mass or mass-effect. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. There is mild nonspecific prominence of the nasopharyngeal soft tissues which may be related to lymphoid hyperplasia. There is also nonspecific low T1 marrow signal without suspicious lesions.IAC: The internal auditory canals are symmetrical and normal in size and signal intensity. The inner ears are normal, with normal T2 signal and no pathological enhancement. No abnormal mass or abnormal enhancement is seen within the cerebellopontine angle, cisterns bilaterally or within the internal auditory canals.
MRI of the brain appears within normal limits. Specifically no mass or abnormal enhancement is appreciated within the brain stem, involving the cranial nerves, or at the skull base. Please note patient chose to reschedule MRI neck study and is pending.