Clinical question: New onset of seizure. Signs and symptoms: As above. Pre- and post enhanced lumbar MRI:Negative diffusion weighted images.Examination redemonstrate moderately extensive periventricular and to a lesser degree subcortical, bilateral basal ganglia and minimally pontine foci of nonspecific FLAIR hyperintensity without gross interval change since prior exam. Although nonspecific the findings at this age group often are result of microvascular ischemic changes. This findings are not associated with any susceptibility signal changes and are nonhemorrhagic.There is resultant mild ex vacuo dilatation of lateral ventricle however with maintained midline.Examination fail to demonstrate findings to account for patient's seizure.Post contrast images demonstrate no detectable abnormal parenchymal or leptomeningeal enhancement. There is also normal signal intensity of the calvarium without abnormal enhancement. Unremarkable images through the orbits without enhancement.Signal void of major intracranial arterial branches are identified. The signal intensity of intracranial venous sinuses are within normal and with normal pattern of enhancement.
1.No acute intracranial process.2.Findings suggestive of chronic nonhemorrhagic small vessel ischemic strokes of moderate degree without gross interval change.3.No detectable abnormal enhancement.4.No finding to account for patient's recent seizure.