Questionable Parkinsonian features with numbness to lower extremity. Image quality is degraded by motion artifact. The ventricles and sulci are prominent, consistent with moderate age-related volume loss and slightly more prominent involving the right anterior temporal lobe. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with moderate chronic small vessel ischemic changes. There is a focus of CSF signal involving the left medial basal ganglia adjacent to the foramen of Monro which may represent a lacunar infarct or possibly perivascular space. There is no midline shift or herniation. There is thinning of the right sphenoid bone as seen on recent CT with areas of lucency seen on CT possibly representing prominent arachnoid granulations/related to CSF pulsation. The skull and extracranial soft tissues are otherwise unremarkable. Scattered mucosal thickening of the paranasal sinuses.
1. Image quality is degraded by motion artifact. No evidence of acute infarct, intracranial mass or mass effect.2. Moderate chronic small vessel ischemic disease.3. There is thinning of the right sphenoid bone with areas of lucency seen on CT possibly representing prominent arachnoid granulations/related to CSF pulsation and of doubtful clinical significance. There is global parenchymal volume loss, commensurate with age, but slightly greater in the right anterior temporal lobe.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.