Nausea with vomiting, unspecified [R11.2], Reason for Study: ^Reason: W contrast only, evaluate brainstem lesion History: diplopia, vertigo, vomiting There is subtle somewhat patchy enhancement on the anterior pial surface of the mid-pons which slightly extends toward left side on 3D SPGR sequence. However, there is no MR evidence of the same enhancement on conventional post enhanced MRI (series 401). Since 3D SPGR sequence was obtained slightly delayed (about 5min), this could indicate delayed enhancement of pial surface indicating low grade inflammatory lesion. However, mid-pons area on 3D sequence is a frequent site for an artifacts. Therefore, it is hard to emphasize the clinical significance of this findings. Clinical correlations including if needed CSF analysis may be helpful for further evaluation.There is no other abnormal enhancement seen on this scan. The ventricles, sulci and cisterns are symmetric and unremarkable.
Subtle delayed enhancement on the anterior pial surface of mid-pons which cannot be differentiated from artifacts as described above. Clinical correlation including CSF analysis can be considered for further evaluation of the finding's clinical significance if indicated. 