66 years Female (DOB:2/5/1950)Reason: dizziness History: dizzinessPROVIDER/ATTENDING NAME: DIANE B CHANEY DIANE B CHANEY 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. These are asymmetrically more numerous in the left frontal lobe compared to the right. There are approximately 10 or 15 and the left frontal lobe and approximately 5 or 6 and the right frontal lobe subcortical white matter. Several additional subcortical white matter lesions are present in the parietal lobes.The periaqueductal gray matter appears hyperintense on T2 and FLAIR imaging. There is no associated contrast enhancement also appears to be a subtle hyperintensity along the mamillary bodies and adjacent inferior hypothalamus.There is a 13 x 15 mm arachnoid cyst in the left middle cranial fossa.No abnormal enhancing 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.Findings suggest some subtle increased signal in the periaqueductal gray matter and mammillary bodies. This is somewhat nonspecific. The possibility of a metabolic disturbance such as Wernicke’s encephalopathy due to thiamine deficiency cannot be excluded. Please correlate with patient's clinical history. Findings were reported to Dr Heyer at the time of this dictation.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.There is no evidence for acute ischemic cerebral infarction.4.Small arachnoid cyst in the left middle cranial fossa.