57-year-old male with seizure-like activity. Evaluate for mass or stroke. There is no evidence of intracranial hemorrhage, mass, or acute infarct. No findings to suggest seizure focus are appreciated. The bilateral hippocampi are symmetric in size, signal characteristics, and with preserved internal architecture. There is scattered periventricular and subcortical white matter T2/FLAIR hyperintensity which is nonspecific. A focus of susceptibility abnormality in the medial left midbrain is seen only on susceptibility weighted images. A small T1 and T2 bright lesion is seen conforming to the undersurface of the right medial tentorium. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Left greater than right maxillary sinus mucosal thickening is seen. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable.
1.There is no evidence of a mass, infarct, hemorrhage or seizure focus.2.Scattered mild chronic likely small vessel ischemic disease.3.Focus of susceptibility abnormality in the medial left midbrain may represent a vascular lesion such as a developmental venous anomaly or focus of capillary telangiectasia for which a contrasted MRI exam may provide further information if clinically warranted.