Female, 46 years old, with worsening ataxia and falls and new right sixth nerve palsy. Again seen is severe atrophy of the right cerebral hemisphere with patchy superimposed nonmasslike parenchymal enhancement. Modest atrophy of the brainstem and left cerebral hemisphere is also redemonstrated.No CP angle or IAC masses are seen. No pathologic enhancement is demonstrated in the basal cisterns, IACs or inner ear structures.The cisternal portions of the sixth cranial nerves are identified and seem to be within normal limits. The eighth cranial nerves are likewise unremarkable bilaterally. The right facial nerve is not well seen and may be somewhat atrophic.No significant cavernous sinus lesions are suspected, though a small laterally directed right cavernous ICA aneurysm is probably revisualized. The right globe deviates nasally compatible with the stated history. The right lateral rectus muscle is somewhat thin.
1.Redemonstration of right greater than left cerebellar atrophy and atrophy of the brainstem.2.No definite CP angle, IAC or cranial nerve lesions are identified.3.The right globe deviates nasally, and the right lateral rectus muscle is somewhat thin which could reflect passive stretch or flaccidity.