Clinical question: Evaluate for changes. Signs and symptoms: Patient with migraine and paresthesias, evaluate for demyelination. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination redemonstrate very few tiny foci of FLAIR hyperintensity only in the subcortical white matter of cerebral hemispheres. The findings are nonspecific, nonhemorrhagic and demonstrate no abnormal enhancement. The signal intensity of brain parenchyma is otherwise within normal in all MRI sequences and without detectable abnormal enhancement. Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces. The signal void of major intracranial arterial branches are identified.The signal intensity of the intracranial venous sinuses are within normal and with normal pattern of enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.All visualized paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
1.No acute intracranial process and no convincing evidence of any new finding since prior exam.2.Stable very few punctate nonspecific foci of FLAIR hyperintensity as detailed.3.Unremarkable pre and post enhanced brain MRI otherwise and stable since prior study.