 Brain:The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position, and normal biphasic CSF flow is noted at the level of the cerebellar tonsils (as well as elsewhere). 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. Note is made of scattered perivascular spaces. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present throughout the paranasal sinuses and there is a superimposed air-fluid level within the left maxillary sinus. The mastoid air cells are clear. Complete spine:The comparison study demonstrated focal, skipping, areas of uniform central dilatation, none greater than 2 mm, which on the current exam appear different. Specifically, some of the areas of "dilatation" are no longer present, and others are smaller. There are no new foci of central canal dilatation.Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The cord is normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable. There are no osseous dysplasias or stenoses.
1.Mucosal thickening is present throughout the paranasal sinuses and there is a superimposed air-fluid level within the left maxillary sinus. Otherwise negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's blank spells.2.The comparison study demonstrated focal, skipping, areas of uniform central dilatation, none greater than 2 mm, which on the current exam appear different. Specifically, some of the areas of "dilatation" are no longer present, and others are smaller. There are no new foci of central canal dilatation. Given the constellation of these features, this is felt to most likely represent transient enlargement of central canal and much less likely syrinx.