41-year-old female with paresthesias and previous abnormal brain MRI, evaluate for progression 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, unchanged over the interval. There are no new lesions, and there are no posterior fossa lesions.The patient is status post suboccipital craniotomy for Chiari I, unchanged in appearanceMild gyral asymmetry between the parietal lobes is stable and may simply represent a developmental asymmetry.There is a redemonstration of a small focus of susceptibility effect in the right centrum semi-ovale associated with central T2 and flair signal hyperintensity, unchanged in appearance, and consistent with a developmental venous anomaly which may be associated with a small cavernous malformationNo 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.Stable periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They are not specific and could be vascular related, related to demyelination, trauma, vasculitis, or sarcoid. However, they have not changed significantly when compared to the previous exam.2.Stable postsurgical changes from prior suboccipital craniotomy for Chiari decompression.