 The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Incidental small parafalcine calcification is again noted. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. The optic nerves, chiasm, and tracts appear normal. There is no optic nerve sheath dilatation. The extraocular muscles are normal and symmetric. The globes appear normal. No retinal detachment or vitreous clouding. The lacrimal glands are symmetric and within normal limits for size. No orbital mass lesion.
Although pre-and postcontrast MRI was ordered of the brain and orbits, the patient refused to continue. Several repeat sequences were obtained to attempt to acquire a diagnostic study. The patient became nauseous before contrast could be administered. Thus, contrast could not be administered which limits the sensitivity of the study. Given these caveats, negative noncontrast MRI of the brain and orbits. Specifically, there are no noncontrast MRI findings to explain the patient's symptoms.