History of new visual changes, seizure/seizure-like events, stroke. Evaluate for structural abnormality. There is no evidence of intracranial hemorrhage, mass, or acute infarct. This is an area of high T2 signal and perhaps mild swelling within the inferior left postcentral gyrus involving both the gray and white matter that measures up to approximately 20 mm. There is an additional linear area of high T2 signal with perhaps mild volume loss predominantly involving the white matter of the superior left postcentral gyrus that measures up to approximately 15 mm. There are a few additional punctate foci of high T2 signal cerebral white matter and pons. There are also subcentimeter foci of high T2 signal in the bilateral basal ganglia. The pituitary gland appears unremarkable. 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 orbits, skull, and scalp soft tissues are grossly unremarkable. There is trace mucosal thickening within the paranasal sinuses. There is an area of high T2 and low T1 signal in the left petrous apex region that measures up to approximately 15 mm.
1. No evidence of acute ischemic infarction.2. A lesion in the left parietal lobe which are nonspecific but may reflect sequela from prior infarction with superimposed effects related to seizure versus a neoplasm. However, assessment is limited due to the lack of intravenous contrast.3. A lesion with possible mild volume loss predominantly involving the white matter of the superior left postcentral gyrus that measures up to approximately 15 mm may represent sequela from prior infarction.4. Probable chronic bilateral basal ganglia lacunar infarcts.5. Incompletely characterized area of high T2 and low T1 signal in the left petrous apex region that measures up to approximately 15 mm. This likely represents trapped secretions versus less likely a chondroid matrix tumor. An MRI with contrast may also be useful for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.