Dizziness and giddiness [R42], Reason for Study: ^Reason: Chronic vertigo History: Above without nystagmus IAC MRIThere is about 4mm x 2mm sized lenticular shaped T1 high signal intensity lesion at the right IAC (series 1401, image 12/20). There is no evidence of mass effects toward adjacent CN 7, 8 or bony IAC. However, the lesion is not seen on any other sequences including post enhancement scans. Therefore, this could represent fat containing non enhancing lesion such as small dermoid or lipoma or dural extension with fatty component. Follow up can be considered if clinically indicated.The brainstem, cerebellum, vermis and tonsils are normal. The inner ear structures, cochlea, vestibule, semicircular labyrinth are normal. The internal auditory canals are normal with delineation of the facial, cochlear and vestibular nerves except above described right IAC lesion. No evidence of signal abnormality, mass or abnormal enhancement is noted. Brain MRINo evidence of acute ischemic or hemorrhagic lesion.Bilateral (left more than right) superior parietal lobule encephalomalacia are seen with gyriform low signal intensities indicating prior hemorrhagic lesion.Scattered periventricular white matter high signal intensity lesions on FLAIR indicate non specific small vessel ischemic disease.The ventricles, cerebral sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast-enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Likely an artifact at the right IAC as described above with the differential diagnosis of dermoid, lipoma or fatty infiltration of dural extension. Follow up can be considered.2. Chronic hemorrhagic lesions on bilateral superior parietal lobules as described above.3. Non specific small vessel ischemic disease.4. No evidence of acute ischemic or hemorrhagic lesion. 