CN IV palsy. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a mildly prominent perivascular space in the left middle cerebral peduncle. Otherwise, the brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The cavernous sinuses and orbits are intact. The cisternal segments of the abducens nerves bilateral appear unremarkable. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
No evidence of mass lesions along the course of the right abducens nerve or in the brainstem. 