17 years Female (DOB:7/2/1998)Reason: structural abnormalities History: migraines with visual changes, losing visionPROVIDER/ATTENDING NAME: PATRICIA OGDEN MICHAEL H. KOHRMAN 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 A1 segment appears to be small.The visualized portions of the paranasal sinuses demonstrate opacification of the frontal sinuses and some minor mucosal thickening in the ethmoid air cells and maxillary 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 .
1.There is no evidence for mass lesion in the midbrain or other lesion within the brain parenchyma to explain the patient's migraines.2.No mass lesion or other abnormalities identified within the orbits.3.There is opacification of the frontal sinuses bilaterally associated with a small amount of opacification of anterior ethmoid air cells. This nonspecific. It's most likely inflammatory in nature. A point of obstruction is not clearly defined on this exam.