Pt with gait/balance issues; ? Possible parkinsonism, PSP The CSF spaces are appropriate for the patient's stated age with no midline shift. There are several punctate subcortical white matter lesions present which are right on T2 and FLAIR MRI and not associated with diffusion restriction or contrast enhancement nor susceptibility effect.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.No abnormal mass lesions are appreciated intracranially that would explain the patient's symptoms.2.There are several subcortical white matter punctate-sized lesions which are probably of little clinical significance and not unusual in this age group