64-year-old female with a history of Meniere's disease, trigeminal neuralgia, and migraines. Facial pain. The study is limited for the technique and patient motion.Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma is notable for nonspecific frontoparietal T2 hyperintense lesions which may reflect microvascular ischemia. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The sella turcica is enlarged and fluid filled, compatible with empty sella turcica. The right eye lens is replaced. The orbits are otherwise unremarkable. There is minimal fluid in the mastoid air cells.Internal Auditory Canals/Trigeminal Nerves:The cisternal segments of the trigeminal nerves are unremarkable. There is no vascular loop. The Meckel's caves are also symmetric. The cavernous sinuses are normal. Postcontrast images show no abnormal contrast enhancement. There is no brainstem lesion.The internal auditory canals are symmetric. The seventh/eighth cranial nerve complexes are also unremarkable. The endolymphatic sac and duct are not well delineated on 3-D T2 images, although these are somewhat limited by slice thickness artifact. Inner ear structures are normal. The right parotid gland is enlarged though without a focal lesion or abnormal signal. There is asymmetric T2/FLAIR hyperintense signal within the right petrous apex, likely relating to fluid and asymmetrically pneumatized bone. There is mild associated peripheral enhancement in these areas.
1.The study is limited because of technique and patient motion as described above.2.There are small T2 hyperintense cerebral white matter lesions which are nonspecific but may represent microvascular ischemia.3.There is no definite abnormality in the brainstem or along the course of the trigeminal nerves.4.Asymmetric abnormal fluid signal in the right petrous apex without expansion relating to opacification of asymmetric pneumatized bone.