 Evaluation of the internal auditory canals is limited without contrast. Given this caveat:There are several scattered foci of T2 hyperintensity throughout the white matter, primarily in subcortical white matter locations, without associated mass effect or restricted diffusion. Incidental note is made of multiple T2 hypointensities along the dura and inner surface of the calvarium at the convexity, most likely representing hyperostosis. This has no significant associated underlying mass effect upon the brain, however is more extensive than that typically seen for a patient of 43 years.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present within the maxillary sinuses. The remaining paranasal sinuses and mastoid air cells are clear. Images of the internal auditory canals demonstrate the seventh and eighth nerves to be normal in size and symmetric bilaterally without masses along the course of these nerves or in the cerebellopontine angle cisterns bilaterally. The inner ear structures are normal in appearance and symmetric bilaterally.
1.There are several scattered foci of T2 hyperintensity throughout the white matter, primarily in subcortical white matter locations, without associated mass effect or restricted diffusion. These are nonspecific in appearance yet abnormal for patient age. The most likely differential diagnosis would include small vessel disease, vasculitis, less likely demyelination, or other etiologies as directed by clinical history.2.Negative, limited noncontrast MRI of the IACs.