Concern for critical process requiring surgery: shaking of the arm and leg, vertigo. Brain MRI: There is an unchanged mildly expanded partially-empty sella. The Meckel's caves also appear prominent, which is unchanged. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are mild nonspecific scattered T2 hyperintense foci in the cerebral white matter. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Brain MRA: There is no evidence of significant steno-occlusive lesions or aneurysms.Neck MRA: There is no evidence of significant steno-occlusive lesions.
1. An unchanged mildly expanded partially-empty sella can be a manifestation of pseudotumor cerebri or may be age-related, but is nonspecific. Otherwise, no evidence of acute intracranial hemorrhage, mass, or acute infarct.2. No evidence of significant steno-occlusive arterial lesions in the head and neck.