Unspecified epilepsy without mention of intractable epilepsyClinical question: patient with black out episodes, work up for seizure focusSigns and Symptoms: black out episodes The CSF spaces are appropriate for the patient's stated age with no midline shift. There are multiple punctate foci of signal loss on susceptibility imaging present in the subcortical white matter of the occipital lobes, the left side of the corpus callosum and the subcortical white matter of the right frontal lobe as well as a periventricular white matter adjacent to the temporal horn of the right lateral ventricleNo abnormal 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 a mucous retention cyst in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
There is a mild degree of the microhemorrhages present predominantly in the occipital and frontal lobe subcortical white matter but also in periventricular white matter. This is nonspecific.