81 years Male (DOB:2/28/1935)Reason: reversible dementia, posterior circulation, imbalance causes History: memory loss, imbalancePROVIDER/ATTENDING NAME: MEGAN J HUISINGH-SCHEETZ MEGAN J HUISINGH-SCHEETZ MRI of the brainThe 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. There are patchy lesions within the thalami and brainstem which are also high signal on T2 and FLAIR MRI. A couple punctate lesions are present in the cerebellar hemispheres.A small focus of susceptibility effect is present along the dentate nucleus of the right cerebellar hemisphere.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 demonstrate a mucous retention cyst in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. There is a fenestration of the proximal left A2 segment. The posterior communicating arteries are identified and are small.. The right vertebral artery is larger than the left vertebral artery. There is extracranial origin the left posterior inferior cerebellar.
1.Periventricular and subcortical white matter lesions as well as lesions in the brainstem and cerebellum of a mild degree are nonspecific. At this age they are most likely vascular related. 2.Findings are compatible with old lacunar infarcts in the thalami bilaterally.3.There is no evidence for acute ischemic cerebral infarction.4.There is no evidence for intracranial cerebrovascular occlusion or stenosis. There is no evidence for intracranial aneurysm on the basis of this exam.