69 years Female (DOB:6/3/1947)Reason: ?mass or lesion of posterior circulation History: headachePROVIDER/ATTENDING NAME: NAOUM P ISSA NAOUM P ISSA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are largely unchanged since the prior exam. Additionally there are punctate foci of T2 and FLAIR signal hyperintensity within the brainstem which are also largely unchanged since prior exam.Some punctate foci of signal loss and susceptibility imaging are present in the cerebellum predominantly within the vermis..No 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 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 visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.An 8 mm nodule in the right parotid space at the anterior aspect of the superficial portion of the right parotid gland was also present on the prior exam and remains unchanged. It is hyperintense on T2 and hypointense on T1 and FLAIR suggesting that it is cystic
1.Periventricular and subcortical white matter lesions of a mild to moderate degree and punctate lesions within the brainstem are nonspecific. At this age they are most likely vascular related. 2.Microhemorrhages identified within the cerebellum are nonspecific.3.Subcentimeter cystic lesion in the right parotid gland remains stable.