Clinical question: Evaluate cause of transient left inferior quadrant black spots. Signs and symptoms: As above. Nonenhanced brain MRI:No diffusion weighted abnormalities. The anatomical morphology and signal intensity of brain parenchyma is within normal on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination for age.The signal void of major intracranial arterial branches are identified. The signal intensity of intracranial venous sinuses are within normal.Unremarkable calvarium and soft tissues of the scalp.Unremarkable limited images through the orbits.Mild acute right maxillary sinus disease and minimal bilateral anterior ethmoid and frontal sinus disease. Bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.Nonenhanced MRI of orbits:There is normal signal intensity and retro-orbital fat.There is normal signal intensity, morphology and size of the extraocular musculature bilaterally.Normal signal intensity and caliber of the bilateral optic nerves in the retrocrural space as well as their cisternal component and the chiasm.Normal signal intensity, morphology and signal intensity at bilateral globes and bilateral lacrimal glands. Normal signal intensity, size and morphology of bilateral cavernous sinuses. Unremarkable images through the basal cistern and pituitary. Unremarkable pre-septal periorbital soft tissues.Nonenhanced brain MRA:Unremarkable bilateral internal carotid arteries across the skull base and in their supraclinoid segments. Unremarkable bilateral anterior and middle cerebral arteries and their branches.Unremarkable bilateral intracranial vertebral arteries, bilateral pica branches, basilar artery, superior cerebellar and bilateral posterior cerebral arteries.
1.Unremarkable nonenhanced brain MRI. Mild acute on chronic sinusitis as detailed.2.Unremarkable nonenhanced MRI of the orbits.3.Unremarkable nonenhanced brain MRA.