History of lymphoma and Bell's Palsy. Please evaluate MRI for change since last. There appears to be mild diffuse asymmetric enhancement of the geniculate, tympanic, and descending segments of the right facial nerve, with sparing of the canalicular and labyrinthine segments. There also appear to be secretions in portions of the middle ear, mastoid air cells and pneumatized petrous apex on the right side. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is unchanged diffuse periventricular white matter T2 hyperintensity. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a right lens implant.
1. Persistent mild diffuse enhancement of portions of the right facial nerve, as well as persistent nonspecific right otomastoid and petrous apex effusions, although comparison with the prior exam is limited due to differences in technique. Differential considerations include an inflammatory process versus perhaps lymphoma.2. No evidence of intracranial hemorrhage, mass, or acute infarct. 