Left face and arm sensory deficit. MRI: There is mild scattered T2 hyperintensity in the periventricular and subcortical white matter bilaterally, There is no evidence of acute infarction, intracranial hemorrhage, or mass. There is mild enlargement of the ventricles, which may be somewhat out of proportion to the prominence of the sulci. There are secretions and mucosal thickening in the left maxillary sinus. The skull appears unremarkable. There are bilateral lens implants.MRA: There is no evidence of significant steno-occlusive lesions in the head and neck arteries, aside from minimal irregularity in the bilateral carotid siphons from calcifications. There is no evidence of cerebral aneurysms. There is a mildly prominent pannus posterior to the dens and mild irregularity of the dens itself.
1. No evidence of acute infarction, intracranial hemorrhage, or mass.2. Enlargement of the ventricles is somewhat out of proportion to the margin of the sulci. This could relate to normal pressure hydrocephalus in the correct clinical setting versus central cerebral volume loss.3. Nonspecific supratentorial white matter abnormality most likely relates to chronic small vessel ischemic disease.4. No evidence of significant steno-occlusive lesions in the head and neck arteries.5. A mildly prominent pannus posterior to the dens and mild irregularity of the dens itself may be degenerative in nature or perhaps the sequela of a prior inflammatory process.