Clinical question: New onset of dystonia, concern for Wilson's disease versus ischemia. Signs and symptoms: Dystonia. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination demonstrates normal anatomical development, morphology and with normal signal intensity on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.There is no detectable abnormal enhancement of the brain parenchyma or the leptomeninges.The signal void of major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are within normal and with normal pattern of enhancement.Unremarkable images through the orbits including axial fat sat post enhanced series.Unremarkable calvarium and soft tissues of the scalp without abnormal enhancement.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
Unremarkable pre and post enhanced brain MRI.