68 years, Male, h/o OLT in 1996, DMII, HTN, here with unexplained hyponatremia. No intracranial mass or mass-effect. Scattered 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. The ventricles are within normal limits in size and configuration. No evidence of cerebral edema. No restricted diffusion to suggest acute ischemia. There are foci of susceptibility along the surface of the right lateral ventricle in the periatrial region, in the right parietal corona radiata, and left cerebellar hemisphere compatible with chronic microhemorrhages. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.There is a partially empty sella which can be normal variant. Dedicated sequences of the pituitary gland were not obtained; however, it appears grossly unremarkable including presence of the T1 hyperintensity of the neurohypophysis. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No specific findings to explain patient's hyponatremia/SIADH. No evidence of intracranial neoplasm. 2. Mild chronic small vessel ischemic changes.3. Scattered foci of chronic microhemorrhage in a nonspecific distribution.4. Partially empty sella, which can be a normal variant. 