Clinical question: Evaluate posterior fossa. Signs and symptoms: Dizziness. Nonenhanced brain MRI:Unremarkable diffusion weighted series and without evidence of acute ischemic stroke. The and T2-weighted images demonstrate few punctate foci of periventricular subcortical hyperintensity. The findings are nonspecific however in the proper clinical setting and the risk factors possibility of minimal chronic small vessel ischemic strokes should be considered.There is mild degradation of images secondary to motion artifact. Within this limitation however there is no convincing evidence of any additional foci of parenchymal signal abnormality. The cortical sulci, ventricular system, CSF spaces and myelination the brain is otherwise within normal.Signal void of major intracranial arterial branches are identified.There is a tiny well-demarcated extra axial dural based lesion with T2 hypointensity signal in the right posterior parietal high convexity. Review of prior head CT exam demonstrate heavy calcification of this lesion. The finding is highly suggestive of a burned out calcific meningioma measuring at approximately 6 mm in size.Unremarkable calvarium, soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells. There is normal anatomical variation of partially empty sella.Nonenhanced brain MRA:There are normal appearing bilateral vertebral arteries, basilar artery, bilateral pica and aica branches and bilateral superior cerebellar and posterior cerebral arteries.Unremarkable bilateral internal carotid arteries, bilateral middle and anterior cerebral arteries and their branches. No abnormality of the anterior communicating artery is detected. A tiny right posterior communicating artery is present and there is normal anatomical variation of absent left posterior communicating artery.Enhanced neck MRA:The visualized aortic arch and the origins of major vessels are unremarkable.Right brachial cephalic vein and bilateral subclavian arteries are unremarkable.Unremarkable bilateral common, external and internal carotid arteries.Unremarkable bilateral vertebral arteries.
1.Nonenhanced brain MRI demonstrates no acute ischemic process. Few subcortical and periventricular punctate foci of flair hyperintensity are a nonspecific finding. In proper clinical setting this appearance could represent mild chronic small vessel ischemic strokes. A tiny 6 mm right posterior parietal extra-axial meningioma is detected as detailed above.2.Unremarkable nonenhanced brain MRA. 3.Unremarkable enhanced neck MRA.