Diagnosis: Migraine without aura, not intractable, without status migrainosusClinical question: Evaluate for etiology of increased frequency of migrainesSigns and Symptoms: as above with blurry vision The CSF spaces are appropriate for the patient's stated age with no midline shift. There several periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.
There is no evidence for intracranial mass lesion. A few periventricular and subcortical punctate lesions are very commonly seen and likely of little clinical significance. They are nonspecific. They have been observed in association with migraines, however, they are nonspecific. They could also be vascular related or related to trauma but in general given their small number, they are likely of clinical significance