Clinical question: Seizure protocol, patient with spells of inattention and right-sided weakness likely nonepileptic. Signs and symptoms: History of spells, with inattention and right-sided weakness and likely nonepileptic. Pre and post enhanced brain MRI:No diffusion-weighted findings.Examination demonstrate multiple small foci of periventricular and minimally of subcortical FLAIR/T2 hyperintensity which are nonspecific, nonenhancing and nonhemorrhagic. This appearance in proper clinical setting could represent chronic small vessel ischemic strokes of mild degree. There is minimal interval progression of the findings since prior exam from brain MRI from 2010.The anatomical morphology and signal intensity of the brain is otherwise within normal on all MRI sequences and without detectable abnormal parenchymal or leptomeningeal enhancement.The signal void of major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are within normal and with normal pattern of enhancement on this nondedicated study.Unremarkable calvarium and without abnormal enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization with the exception of the small right maxillary retention cyst.
1.Negative diffusion-weighted images.2.Findings suggestive of mild chronic small vessel ischemic strokes as detailed.3.Unremarkable pre and post enhanced brain MRI otherwise.