62 years Male (DOB:5/11/1954)Reason: evaluate for cental nervous system cause of syncope. History: Hx of brain trauma as a child - fall from heightPROVIDER/ATTENDING NAME: JAMES X TAO JAMES X TAO 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.On susceptibility weighted imaging is a punctate focus of signal loss present in the left pons which is unchanged since prior exam. Previously noted susceptibility effect adjacent to the thalamus and hippocampal tail probably represent vascular structures including an asymmetrically large right-sided basal vein of Rosenthal and inferior ventricular vein. This is evident on the postcontrast images.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 intracranial cerebral vasculature appears mildly ectatic.The visualized portions of the paranasal sinuses demonstrate a mucous retention cyst in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Examination is somewhat degraded due to patient motion artifact.
1.Examination is mildly degraded due to patient motion artifact which may obscure more subtle abnormalities. Simulation is stable compared to the previous exam from September.2.Microhemorrhages present in the left pons which in isolation is probably of little clinical significance.3.Intracranial cerebral vascular ectasia is a nonspecific finding.4.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 