75 years, Female, Reason: Tremor, worse with action (such as finger to nose, where tremor becomes coarse). Difficulty with tandem gait (falls/steps rightward). Evaluate for cerebellar disease. There is mild volume loss involving the cerebellar hemispheres. There is also a tiny linear focus of T2 hyperintensity in the right cerebellar hemisphere suggestive of a small chronic infarct. Otherwise no significant abnormality in the cerebellum is appreciated. There is also mild supratentorial parenchymal volume loss, which is appropriate for age. No intracranial mass or mass effect. No midline shift or herniation. No hydrocephalus. Calvarium and extracranial soft tissues are grossly unremarkable.Degenerative changes in the cervical spine with spinal canal stenosis better assessed on recent MRI from 8/11/2016.
1. No evidence of acute infarct, hemorrhage, or mass.2. Mild cerebellar and supratentorial parenchymal volume loss, which appears within normal limits for age. There is also a suggestion of a tiny chronic right cerebellar infarct. Brain MRI is otherwise unremarkable for age.