39 years Female Reason: yearly surveillance of 5mm 7th nerve lesion History: loss of hearing left ear Provider Name: ISSAM A. AWAD ISSAM A. AWAD BRAINThe CSF spaces are appropriate for the patient's stated age with no midline shift. 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 demonstrate small mucous retention cysts.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.IACNo abnormal foci of enhancement are appreciated within the internal auditory canals. The cochlea and semicircular canals appear intact. The cochlear nerve can be followed bilaterally tracking into the cochlea. The modiolus is well formed bilaterally.There is a 4 mm enlargement of the right geniculate ganglion does not appear to be different than the prior exam from 6/6/2015. The basilar artery is not tortuous and does not abut the trigeminal nerves. To the extent of visualization no significant arterial vascular structure abuts the trigeminal nerves. The left petrosal vein appears to be adjacent to the trigeminal nerve which is not unusual
There is a 4 mm enlargement of the right geniculate ganglion does not appear to be different than the prior exam from 6/6/2015. This can be seen on the temporal bone CT. Is not well documented on this MRI exam. On the prior CT of the temporal bones it appears to break through the tegmen tympani. Please note that contrast-enhanced MRI exams or more sensitive in the detection of cranial nerve lesions compared to noncontrast MRI exams. The basilar artery does not abut the trigeminal nerves.