 There is a 7-mm focus of restricted diffusion with matching ADC hypointensity and T2 hyperintensity, without enhancement or susceptibility abnormality, involving the right cerebellar tonsil.There are a few scattered foci of T2 hyperintensity within the white matter without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. There is enhancement within the distal right IAC which extends into the labyrinthine section of the facial nerve, to the geniculate ganglian, involving the horizontal facial segment, terminating at the descending portion of the facial nerve.The remainder of the right IAC components, as well as the left IAC components, are unremarkable.
1.7-mm focus of acute ischemia involving the right cerebellar tonsil of uncertain etiology or significance.2.Mild chronic small vessel ischemic disease.3.Asymmetric and abnormal enhancement the right facial nerve extending from the distal IAC to its descending segment.4.Findings were discussed with Dr. Kelly on 4/11/2015 at approximately 11:05 a.m.