46 years, Male, chronic headaches. Patient had MRI scheduled today but syncopal episode brought him to the emergency department. No intracranial mass or mass-effect. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Some of these foci are less conspicuous compared to prior likely due to differences in technique. Brain parenchyma is otherwise unremarkable for age. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Mastoid air cells are clear. Scattered paranasal sinus opacification is again seen including mild mucosal thickening involving the bilateral maxillary sinuses, right greater than left, as well as mild ethmoid and sphenoid sinus opacification. Evidence of prior endoscopic sinus surgery again seen. Sinus opacification is improved since 6/14/2016 CT. Bone marrow signal and extracranial soft tissues are otherwise grossly unremarkable.
1. No evidence of intracranial mass or mass effect. No evidence of infarct or hemorrhage.2. Mild nonspecific scattered foci of T2/FLAIR hyperintensity which are nonspecific but may represent mild chronic small vessel ischemic disease.3. Scattered paranasal sinus opacification which appears overall improved since maxillofacial CT dated 6/14/2016.