Dizziness and giddiness [R42], Reason for Study: ^Reason: r/o bleeding History: dizziness, nystagmus, hypertensive Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on this scan.Confluent patchy high signal intensity lesions on FLAIR/T2 on bilateral periventricular white matter as well as bilateral cerebellar hemispheres including right side of lower pons (best seen on T2) indicate possibility of demyelinating disease such as multiple sclerosis.There is no evidence of abnormal enhancement.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. There is no evidence of intracranial arterial aneurysm. No evidence of intracranial arterial luminal stenosis.Brain MRV3D MRV brain post-gadolinium with maximum intensity projections of the superficial/deep intracranial venous drainage demonstrate normal flow enhancement in the superior sagittal sinus, transverse sinuses, sigmoid sinuses, internal cerebral veins, vein of Galen and straight sinus.
1. Patchy and confluent high signal intensity lesions distributed mainly on bilateral periventricular white matter as well as posterior fossa likely indicating demyelinating disease such as multiple sclerosis.2. Normal brain MRA and MRV. 