39-year-old male with progressive dysphagia, concern for LMN neuropathy or variant ALS. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The corticospinal tracts are relatively T2 hyperintense in the basal ganglia regions bilaterally. 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. There is mild mucosal thickening of the ethmoid air cells and fluid within the right maxillary sinus. The orbits, skull and scalp soft tissues are grossly unremarkable.
The corticospinal tracts are relatively T2 hyperintense, which can be a normal finding or a feature or ALS. Otherwise, no evidence of intracranial hemorrhage, mass, or acute infarct. 