 Brain MRI:There are a few scattered punctate foci of T2 hyperintensity within bifrontal subcortical white matter, without restricted diffusion, susceptibility abnormality, or enhancement. The ventricles and sulci are normal in size; incidental note is made of a cavum septum pellucid et vergae. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present within the inferior aspect of bilateral maxillary sinuses. The remaining paranasal sinuses and mastoid air cells are clear. Incidental note is made of a a few postinflammatory cysts within the nasopharynx. There is no abnormal enhancement within the brain. Cervical spine MRI:There is straightening of the cervical spine which is likely positional. The marrow signal is benign. The cervical and upper thoracic cord is normal in signal without abnormal enhancement. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable. There is no significant degenerative disease or stenoses. There are no abnormal enhancing foci.
1.There are a few scattered punctate foci of T2 hyperintensity within bifrontal subcortical white matter, without restricted diffusion, susceptibility abnormality, or enhancement. These are nonspecific in appearance, and the differential diagnosis would most likely include small vessel disease, migraine sequelae, or residua from previous head trauma. Given lesional morphologies and locations, demyelination is to be unlikely.2.Negative contrast enhanced cervical spine MRI.