22 years Female (DOB:8/15/1993)Reason: eval for structural abnormality or MS lesions History: left sided headache, intermittent LUE numbness, nausea and vomiting of unknown etiologyPROVIDER/ATTENDING NAME: BRUCE M BISSONNETTE BRUCE M BISSONNETTE The CSF spaces are appropriate for the patient's stated age with no midline shift. There is abnormal signal present within the medulla and visualized upper cervical spinal cord. There is no diffusion abnormality associated with this. The medulla itself appears expanded at the level of the signal abnormality. There is no significant contrast enhancement associated with this lesion. No hemorrhage is appreciated in association with this lesion on this exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Abnormal infiltrative type lesion encompassing much of the medulla. Differential considerations include low-grade neoplasm such as astrocytoma (i.e. brainstem glioma). An inflammatory condition is less likely but can't be excluded.2.An email was sent to Dr Jacobs at the time of this dictation (not pageable via our system).