Reason: transverse myelitis please eval for brain involvement History: TM new onset The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a vague signal hyperintensity on T2 and flair MRI along the middle cerebellar peduncles bilaterally (right more than left) and left midbrain . There is not associated contrast enhancement and no associated micro-hemorrhage.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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 visualized portions of the paranasal sinuses there is partial opacification of the right maxillary sinus with an air-fluid level in the right maxillary sinus. The visualized portions of the mastoid air cells are partially opacified. The visualized portions of the orbits are intact.
1.Vague signal hyperintensity in the middle cerebellar peduncles (right more than left) and left midbrain is a nonspecific finding. It could relate demyelination or other inflammatory process such as a viral illness or other inflammatory process.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Air-fluid level in the right maxillary sinus is non-specific but could relate to acute sinusitis.