Reason: Probable neurosarcoidosis; evaluate for progression History: paresthesias The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The patient is status post suboccipital craniotomy for Chiari I.A small focus of cortical dysplasia is present in the right parietal lobe.There is a redemonstration of a small focus of susceptibility effect in the right centrum semi-ovale associated with central T2 and flair signal hyperintensity.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. They have not changed significantly when compared to the previous exam.2.The patient is status post suboccipital craniotomy for Chiari I. there is no evidence for ventriculomegaly on the current exam.3.A small focus of cortical dysplasia is present in the right parietal lobe.4.A small hemorrhagic appearing lesion in the right centrum semi-ovale is nonspecific. It is stable since prior exams