49 years, Female, 1.5 yrs swallowing difficulty and hoarseness, normal neuro exam w/ some hyperreflexia 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. Cerebellar tonsils are borderline low measuring up to 5 mm below the foramen magnum without clear evidence of Chiari I. No significant crowding in the posterior fossa. Minimal foci of T2/FLAIR hyperintensity are seen in the white matter including the left frontal and left parietal lobe which are nonspecific. There is otherwise no significant parenchymal signal abnormality. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid air cells are grossly clear. No focal lesions are seen in the calvarium. There is nonspecific T1 hypointensity in the bone marrow which is nonspecific.
1. Brain MRI is essentially unremarkable for patient's age. There are minimal foci of T2/FLAIR hyperintensity in the white matter which are nonspecific and not unusual for patient's age. There is also mild cerebellar tonsillar ectopia without significant crowding in the posterior fossa or clear evidence of Chiari I.2. Nonspecific T1 hypointensity of the bone marrow which can be seen with a variety of hematologic conditions such as chronic anemia. 