Diagnosis: Syncope and collapseClinical question: mass or anatomic abnormality to explain symptomsSigns and Symptoms: repeated syncope, both associated with sudden emesis The CSF spaces are appropriate for the patient's stated age with no midline shift. Some mild asymmetry in the size of the lateral ventricles (right slightly larger than left) can be considered a normal variantNo abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is no evidence for intracranial hemorrhage.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 right vertebral artery is larger than the left vertebral artery.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
MRI of the brain is within normal limits