Diagnosis: Unspecified fall. Muscle weakness (generalized). Dizziness and giddinessClinical question: Please eval for stroke, posterior circulationSigns and Symptoms: 63 yo M with HTN, Hyperthyroidism uncontrolled, presents with left sided weakness and overall dysequilibrium, several fallsComments: Has tolerated Gadolinium on prior MRI in 2014 here. | 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. This is stable compared to the prior exam .No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.No foci of signal loss on susceptibility imaging are appreciated.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 demonstrate a mucous retention cyst in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. This is stable compared to the prior exam 2.There is no evidence for intracranial mass lesion and no evidence for acute ischemic cerebral infarction.