71 years, Male, with tremor, preoperative planning. Examination is limited to sequences for operative planning and intraoperative navigation. There are focal areas of volume loss involving the posterior cerebellar hemispheres bilaterally likely related to chronic infarcts but new since prior from 10/13/2011. There is also mild generalized volume loss supra and infratentorially. There are scattered foci of susceptibility effect consistent with chronic microhemorrhages including the left posterior frontal lobe, left posterior temporal lobe, bilateral parieto-occipital lobes as well as the left cerebellar hemisphere. No intracranial mass or mass effect. Specifically no lesions are abnormal vascular structures are seen along the expected trajectory of DBS leads. No hydrocephalus or extra-axial collections. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. There is mild opacification throughout the paranasal sinuses including multiple small bilateral maxillary mucus retention cysts.
1. Examination for operative planning and intraoperative navigation. No masses or abnormal vascular structures are seen along the expected trajectory of DBS leads.2. Focal areas of volume loss involving the posterior cerebellar hemispheres bilaterally likely related to chronic infarcts and new since prior from 10/13/2011. 3. Mild generalized volume loss supra- and infratentorially. 4. Multiple foci of chronic microhemorrhage which are predominantly in a peripheral lobar distribution and favored to represent amyloid angiopathy. 