Reason: h/o seizures since teen years History: seizure disorder The CSF spaces are appropriate for the patient's stated age with no midline shift. There are several periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.There is mild cerebellar atrophy present.No abnormal enhancing 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 left vertebral artery appears to be hypoplastic distally.The visualized portions of the paranasal sinuses demonstrate some mild mucosal thickening in the maxillary sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Periventricular and subcortical white matter changes of a mild degree are nonspecific but most likely vascular related. 2.There is mild cerebellar atrophy present. One explanation may be long-term antiseizure medication use.