Diagnosis: Ataxia, unspecifiedClinical question: h/o cerebellar ataxiaSigns and Symptoms: preop planning for DBS The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the T2 images. A high signal focus on T2 imaging is present in the ponsNo abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and left 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 right vertebral artery is very small and may be partially occluded.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate minor opacities. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 2.This is a limited exam for the purpose of DBS planning.3.Findings raise the question of stenosis at the right vertebral artery.4.A high signal focus on T2 imaging is present in the pons. This is nonspecific.