Diplopia [H53.2], Reason for Study: ^Reason: Evaluate for abnormality, further evaluate mid-brain lesion History: Blurry vision, intermittent diplopia Multifocal relatively ill defined FLAIR/T2 high signal intensity lesions on bilateral frontal lobes and paramedian upper right midbrain lesions are again seen. They still show subtle restricted diffusion on ADC maps but the MR signal intensity has been decreased since prior scan.Multiple scattered susceptibility lesions are again seen, unchanged.There is no new hemorrhagic or restricted diffusion lesion on today' scan.There is no evidence of abnormal enhancement on this scan.Constellation of above findings indicate the possibilities of infectious or inflammatory lesions would be low and the possibility of neoplastic lesions could also be low. Therefore, these lesions may represent scattered various aged evolving ischemic lesions.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection or abnormal contrast enhancement. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Previously seen multifocal FLAIR/T2 high signal intensity lesions do not show any evidence of enhancement but decreased the degree of restricted diffusion, thus likely represent evolving ischemic lesions. Possibilities of infectious, inflammatory or neoplastic etiologies would be low.2. No evidence of new ischemic or hemorrhagic lesion. 