Assess olfactory bulb/cleft, as well as sinuses: moderate microsomia and phantosmia, headaches, and fatigue also. The olfactory bulbs and tracts appear to be intact. There is an apparent small defect in the anterior nasal septum and irregularity of the nasal skeleton. There is mild right frontal sinus mucosal thickening. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are punctate right hippocampal sulcus remnant cysts. There is a punctate T2 hyperintense focus in the left caudate head, which may represent a prominent perivascular space or chronic lacunar infarct. The brain parenchyma otherwise appears unremarkable. There is no abnormal intracranial enhancement. The ventricles and sulci are mildly prominent diffusely due to cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable.
1. The olfactory bulbs and tracts appear to be intact. 2. Apparent small defect in the anterior nasal septum and irregularity of the nasal skeleton perhaps related to prior trauma and/or rhinoplasty.3. Mild right frontal sinus mucosal thickening, but otherwise unremarkable paranasal sinuses and olfactory recesses. 4. No evidence of intracranial hemorrhage, mass, or acute infarct. 