 MRI Brain: There is no evidence of intracranial hemorrhage or mass. A punctate area of apparent restricted diffusion in the right pons was present on the prior MRI and is likely artifactual. There are scattered punctate foci and confluent areas of abnormal T2 hyperintensity within the periventricular and subcortical white matter. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There is minimal scattered paranasal sinus mucosal thickening. MRI orbits: There is apparent central T2 hyperintensity within the right optic nerve, which appears to be mildly atrophic diffusely. There is staphylomatous deformity of the right globe. There is silicone oil within the left globe and marked diffuse atrophy of the left optic nerve. The extraocular muscles are unremarkable and there is no abnormal intraorbital enhancement or mass within the orbits.
1. Staphylomatous deformity of the right globe and apparent central signal abnormality in the mildly atrophic right optic nerve may represent artifact or neuropathy, perhaps ischemic in nature, although assessment of acute optic nerve ischemia is otherwise limited.2. Left intraocular silicone oil and marked diffuse optic nerve and chiasm atrophy.3. A punctate area of apparent restricted diffusion in the right pons is likely artifactual.4. Scattered areas of white matter chronic small vessel ischemic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.