Clinical question: Rule out stroke, Parkinson's plus. Signs and symptoms: Rigidity L>R. Pre and post enhanced brain MRI:Negative diffusion weighted series.There is mild prominence of cerebellar vermian folia for patient's stated age 67. Correlate with history and risk factors.Examination otherwise demonstrate normal anatomical morphology and signal intensity of brain parenchyma on all MRI sequences. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.There is no detectable abnormal parenchymal or leptomeningeal enhancement.The signal void of major intracranial arterial branches are identified.Unremarkable images through the orbits including axial fat sat post enhanced series.Unremarkable calvarium and soft tissues of the scalp.Normal pneumatization signal pattern normal paranasal sinuses and bilateral mastoid air cells and middle ear cavities.
1.Negative diffusion-weighted series.2.Mild prominence of the vermian folia for patient's stated age and otherwise unremarkable pre and post enhanced brain MRI.3.Unremarkable orbits, calvarium, paranasal sinuses and mastoid air cells.