Syncope. There is no evidence of acute intracranial hemorrhage or acute infarct. There is a subcentimeter left pons focus of susceptibility effect that corresponds to calcification on CT. There is focal right pons and periventricular frontoparietal white matter T2 hyperintensity. The ventricles and sulci are dilated due to cerebral volume loss. There is a partially empty sella. There is no midline shift or herniation. Partial loss of flow void in the V4 segment of the left vertebral artery correlates with the proximal stenosis described on the recent CTA. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the ethmoid sinuses and left mastoid air cells. The retrodental pannus moderately narrows the upper cervical spinal canal. There is also a posterior disc-osteophyte complex at C3-4 that abuts the spinal cord.
1.No evidence of acute intracranial hemorrhage or acute infarct.2.A subcentimeter left pontine lesion may represent a chronic calcified hemorrhage or cavernous malformation.3.Moderate cerebral and pontine white matter chronic microvascular ischemia and moderate brain volume loss, with slight frontotemporal predominance.