Parkinson's, preoperative planning for DBS placement. Examination is obtained for operative planning. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Multiple foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Slightly prominent perivascular spaces are incidentally noted at the level of the midbrain. There is global parenchymal volume loss, commensurate with age. There is mild fullness and heterogeneous enhancement involving the sella without discrete mass, but is not well evaluated on the limited sequences. Bone marrow signal and extracranial soft tissues are within normal limits.
Examination for operative planning per DBS protocol. No intracranial mass or vascular abnormalities along the expected trajectories of the DBS leads.