Diagnosis: Unspecified disorder of vestibular function, unspecified earClinical question: enhancing lesions in the brainSigns and Symptoms: severe vertigo and unusual looking 2 spots in the brain. History of autoimmune disease MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are asymmetric towards the right hemisphere versus the left. Compared to the prior exam these have not changed.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Cervical Spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine. The exam is mildly degraded by patient motion which may obscure more subtle abnormalities.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina. At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is mild disc desiccation and a minor disc bulge at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are several periventricular and subcortical white matter lesions present which are stable since the prior exam. These are nonspecific.2.The cervical spine exam is mildly degraded by patient motion which may obscure more subtle abnormalities. No cervical spinal cord lesions are appreciated.3.There are minimal degenerative changes present in the cervical spine.