Ataxia There is focal low signal intensity lesion on both T1 and T2 weighted images on the left cerebellar hemisphere with surrounding FLAIR high signal intensities indicating associated encephalomalacia. The gradient echo images were non diagnostic to characterize this lesion due to significant metallic artifacts. Comparing to prior MRI in 2003, the lesion's MR characteristics have not changed. The possibility of this lesion is likely to be chronic hemorrhagic lesion such as cavernoma or calcifications.There are extensive patch high signal intensities on FLAIR imaging on periventricular white matter brainstem, and bilateral cerebral hemispheres indicating moderate to severe nonspecific small vessel ischemic disease.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.There is multilobulated relatively well circumscribed mass on the right parotid gland superficial lobe, the size was measured around 13.8 mm x 24.6 mm x 21 mm. The lesion shows high signal intensity on T2 and low signal intensity on T1 weighted images. Diagnostic possibility is benign parotid gland lesion such as pleomorphic adenoma.
1, Moderate to severe nonspecific small vessel ischemic disease, as described above.2, No evidence of acute ischemic or hemorrhagic lesion on this scan.3. Left cerebellar hemispheric lesion, either cavernoma or calcifications, no change since 2003.4, Benign appearing right parotid gland superficial lobe mass lesion most likely representing pleomorphic adenoma.