Reason: ruleout nmo, demyelinating disorder History: vision loss, changes MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated within the brain parenchyma. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and 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 appears be hypoplasticThe visualized portions of the paranasal sinuses demonstrates partial opacification of the ethmoid air cells, mucosal thickening in the maxillary sinuses and frontal sinuses and partial opacification of the sphenoid sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI orbits:The eyeballs are intact. No intraconal or extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .MRA brain:Antegrade flow is present in the distal internal carotid arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries. The vertebral arteries were not included on this exam. There is fenestration of the anterior communicating artery.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.
1.MRI of the brain and orbits is within normal limits.2.There is no evidence for intracranial aneurysm or cerebrovascular occlusion. The vertebral arteries were not included on the MRA exam.3.Inflammatory changes are present in the paranasal sinuses.