43 years, Male, chronic left-sided headache, mild left Horner's. Rule out structural lesion. Brain: Multiple sequences are mildly motion degraded. There is no restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Few scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with minimal chronic small vessel ischemic changes. There are two small foci of T2 hyperintensity in the right cerebellar hemisphere favored to represent chronic infarcts. Brain parenchyma is otherwise unremarkable for age.No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella is grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. Orbits: Multiple sequences are mildly motion degraded. No abnormal mass or abnormal enhancement is seen. The optic nerves are normal in size and signal intensity, and are symmetric bilaterally. No retrobulbar mass, chiasmatic mass, or parasellar abnormality is seen. Extraocular muscles are unremarkable. Cavernous sinuses are also unremarkable.
1. No evidence of acute infarct, hemorrhage, or intracranial mass effect.2. Two small foci of T2 hyperintensity and volume loss in the right cerebellar hemisphere favored to represent small chronic infarcts. Brain parenchyma is otherwise unremarkable for age.3. MRI of the orbits is also unremarkable.