78 years Female (DOB:1/1/1938)Reason: r/o meningeal irritation; evaluate brain structure History: new onset headaches with dizzinessPROVIDER/ATTENDING NAME: AUDREY L. TANKSLEY AUDREY L. TANKSLEY 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.There appears to be some subtle T2 and FLAIR signal hyperintensity along the subcortical white matter of the temporal lobes and medial aspects of the temporal lobes including hippocampi and along the subependymal space and insular cortex.There appear to be dilated perivascular spaces present. This could represent normal variant.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.There is a subtle signal abnormality involving the limbic system, subependymal region and some of the subcortical white matter of the temporal lobes is nonspecific. This could represent a limbic encephalitis or a paraneoplastic syndrome. It is nonspecific. If clinically appropriate MRI with gadolinium may be of further benefit to further delineate this.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Findings were discussed with Dr Tanksley at the time of this dictation.