Male, 80 years old, with vertigo, nausea and vomiting. History of right acoustic neuroma and TIA. No definite restricted diffusion is seen. A punctate focus of bright diffusion signal along the left precentral sulcus shows no ADC correlate and may therefore be artifactual.Fairly extensive patchy T2 hyperintensity is seen within the cerebral white matter, predominantly in the periventricular regions. Most of this is unchanged relative to the prior examination. However, there is a new focus of FLAIR hyperintensity along the right precentral gyrus without mass effect or edema. Some of these areas of T2 signal abnormality are associated with mild susceptibility.A small focus of encephalomalacia within the left cerebellum is unchanged. No significant parenchymal edema or mass effect is detected. No abnormal extra-axial collections or acute intracranial hemorrhage is noted. The ventricles are stable in size and slightly prominent likely representing parenchymal volume loss.A 7 x 5 mm homogeneously enhancing nodule within the right internal auditory canal has not significantly changed in size or morphology. Both cranial nerves VII and VIII appear to pass through or along this lesion. The lesion is almost entirely contained within the internal auditory canal with no significant extension into the CP angle cistern. The inner ear and IAC structures are otherwise unremarkable.Elsewhere in the brain, no pathologic parenchymal or extra-axial enhancement is seen.A mucous retention cyst in the right maxillary sinus is unchanged.
1.Stable right IAC nodule likely representing a schwannoma. No new inner ear or IAC abnormalities are appreciated.2.Sequelae of fairly extensive chronic small vessel ischemic disease with perhaps some superimposed chronic cortical ischemia. Although no definite acute lesions are appreciated, one small lesion along the right precentral gyrus is new when compared to the prior examination.