History of sarcoidosis. Right-sided facial droop and right upper extremity weakness. Evaluate for CNS involvement by sarcoidosis or stroke. . The study is limited by patient motion, most pronounced on the postcontrast images. There appears to be possible faint enhancement within the right internal auditory canal. There is apparent linear post-contrast high T1 signal along the right post-chiasmatic optic nerve. A small focus of contrast enhancement within the left side of the pons does correlate with susceptibility effect is compatible with a capillary telangiectasia, which is an incidental finding. There are few scattered, punctate T2 hyperintense foci in the frontoparietal white matter without associated diffusion restriction or abnormal contrast enhancement, most likely representing mild chronic microvascular ischemia. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is minimal maxillary mucosal thickening without fluid. The other paranasal sinuses are clear.
The study is limited by motion, especially the post-contrast images, with possible mild enhancement in the right internal auditory canal, which may represent neurosarcoidosis involvement of the facial nerve versus artifact or prominent vessels. Follow up via dedicated internal auditory canal MRI may be useful. Apparent linear post-contrast high T1 signal along the right post-chiasmatic optic nerve may be artifactual versus another potential manifestation of neurosarcoidosis. Otherwise, not evidence of acute infarction or mass lesions.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.