 Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. A few scattered punctate foci of T2 hyperintensities are noted in the subcortical frontal lobe white matter bilaterally. There is no abnormal intracranial enhancement. The cavernous sinuses appear to be intact. 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, paranasal sinuses, and scalp soft tissues are unremarkable. Orbits: There is a disconjugate gaze and apparent mild volume loss of the left lateral rectus. The globes otherwise appear to be intact. The optic nerves, chiasm, and tracts appear normal. There is no optic nerve sheath dilatation. The extraocular muscles are normal and symmetric with physiologic, homogeneous, and intense contrast enhancement. The lacrimal glands are symmetric and within normal limits for size. There is no evidence of orbital mass lesion or abnormal enhancement.
1.Minimal punctate foci of T2 hyperintensities in the subcortical frontal lobe white matter bilaterally, but otherwise no specific findings to suggest a demyelinating process or acute infarct. 2.Apparent disconjugate gaze and mild volume loss of the left lateral rectus related to left abducens nerve palsy, but no discernible mass along the course of the abducens nerve or evidence of brainstem lesions. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.