Anisocoria right pupil greater than left, assess for aneurysm MRI BRAIN: There is diffuse prominence of the cortical sulci in proportion to the cerebral ventricles consistent with moderate global volume loss. Periventricular and subcortical areas of T2/FLAIR hyperintensity are demonstrated. The gray-white matter differentiation is otherwise preserved. No midline shift or mass effect is appreciated. There is no intracranial hemorrhage identified. There is no evidence for acute ischemia.There is a 1.1 x 0.6 cm lobulated T2 hyperintense cystic lesion involving the deep right parotid gland (series 401, image 2).MRA BRAIN:Mild irregularity is demonstrated within left greater than right internal carotid arteries without evidence for flow-limiting stenosis. The MCA's and ACAs appear unremarkable. The bilateral vertebral arteries, basilar artery, and posterior cerebral arteries appear unremarkable as well.
1. Moderate global volume loss and nonspecific subcortical and periventricular white matter changes most likely related to chronic small vessel ischemic change.2. No evidence for acute ischemia.3. MRA of the brain is negative for steno-occlusive disease or aneurysm.4. There is a 1.1 cm lobulated cystic lesion involving the deep lobe of the right parotid gland. Recommend CT of the neck with contrast for further evaluation.Findings were reported to Dr. D. Ferrington on 10/17/2016 at 10:14 AM