71 years, Female, ataxia with new facial weakness. Per chart, history of SCA-8. There is moderate degree of volume loss involving the cerebellar vermis, particularly the superior aspect, and to a mild degree involving the bilateral cerebellar hemispheres. This finding is not significantly changed since prior. There is also mild supratentorial parenchymal volume loss which is perhaps slightly prominent for age, but not significantly changed since 10/24/2009. No significant volume loss involving the brainstem is evident. No significant signal abnormality involving the brainstem, cerebellum, or basal ganglia is evident. Incidentally noted is a punctate focus of enhancement and susceptibility involving the pons compatible with a tiny capillary telangiectasia. This finding is similar to prior allowing for slight differences in technique. No suspicious enhancement or masses along the visualized intracranial course of the cranial nerves, including the trigeminal nerves. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. No hydrocephalus. No extra-axial collections. Multiple foci of T2/FLAIR hyperintensity are again seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. No suspicious parenchymal or meningeal enhancement. Major flow-voids are preserved. Calvarium and remainder of the extracranial soft tissues are unremarkable.
1. Moderate degree of volume loss involving the cerebellar vermis and to a milder degree involving the cerebellar hemispheres, which is nonspecific but compatible with known diagnosis of spinocerebellar ataxia. There is also mild supratentorial parenchymal volume loss which is slightly prominent for age. These findings are not significantly changed since prior study from 10/24/2009. There are also mild chronic small vessel ischemic changes which were also seen before.2. Otherwise no evidence of acute ischemia, hemorrhage, intracranial mass, or mass effect. No suspicious enhancing lesions.