Unspecified disturbances of skin sensation [R20.9] / Spastic hemiplegia affecting unspecified side [G81.10], Reason for Study: ^Reason: CN evaluation History: ? Multiple CN symptoms namely 5 and 7 There is no evidence of acute ischemic lesion scan.There is a 13 mm x 24 mm sized left posterior aspect of the basal ganglia tissue loss which may represent prior hemorrhagic stroke.Multifocal bihemispheric scattered and somewhat patchy high T2 signal intensity white matter lesions indicate non specific small vessel ischemic disease. Since the slice thickness of this imaging study was 3mm with 4mm gap, it is not possible to evaluate cranial nerves precisely. The right cavernous sinus shows low signal intensity on T2 (series 5, image 13/39). The lesion does not show evidence of mass effects against carotid artery but intense enhancement on contrast infusion. This low signal intensity of the right cavernous sinus may indicate partial volume averaging artifacts.Otherwise there is no MR evidence of abnormal enhancement. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.There is mucosal thickening of the right maxillary sinus, bilateral ethmoid sinuses and frontal sinus.
1. No acute ischemic lesion. No abnormal enhancement.2. Chronic hemorrhagic infarction with tissue loss on the right basal ganglia.3. Non specific small vessel ischemic disease.Comment: Since the imaging study was not tailored for cranial nerve examination, the study may need to be repeated without additional charge.