Female, 57 years old, with headaches. Assess for Chiari, dural enhancement. Numerous peri-ventricular and subcortical foci of T2 hyperintensity are seen bilaterally within the cerebral hemispheres. There is no evidence of parenchymal edema or mass effect. No restricted diffusion is seen. No abnormal extra-axial fluid collection or intracranial hemorrhage is detected. The ventricular system is normal in size and morphology. The cerebellar tonsils terminate above the level of the foramen magnum. The globes are slightly misshapen, particularly the right which is elongated in the AP dimension.
1. No evidence of Chiari malformation. Please note that due to lack of IV contrast, dural abnormalities could not be assessed.2. Numerous scattered small foci of periventricular and subcortical T2 hyperintensity are seen. These are nonspecific and may reflect chronic microvascular disease, a demyelinating process, vasculitis or the sequelae of migraines among many other possibilities.