Diagnosis: Sarcoidosis of other sitesClinical question: Eval for sarcoid lesionsSigns and Symptoms: headaches 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. These are stable compared to the prior exam additional punctate T2 and FLAIR hyperintense lesions are present in the brainstem which were also present on the prior exam as well. The preferentially affecting the right pons.No abnormal enhancing 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 changes of a mild degree are nonspecific. At this age they are most likely vascular related. There is stable compared to the prior exam. Additional lesions in the brainstem are also thought to be vascular related and stable since the prior exam.2.There is no convincing evidence for neurosarcoid on this exam. Please note that neurosarcoid may be present in the absence of MR findings.