tuberous sclerosis, concussion, hyponatremia There is no evidence of acute ischemic or hemorrhagic lesion on this scan.On FLAIR images, there are multifocal scattered high signal intensities on subcortical white matter and periventricular white matter indicating non specific small vessel disease. Among them, there is relatively well defined high signal intensity lesion on the Cingulate gyrus (series 7, image 7/28) and right inferior frontal lobe (series 7, image 11/28) but the lesions are more likely confined to subcortical white matter and continuous to other non specific high signal lesions on periventricular white matter. Thus, this is more likely represent extension of small vessel ischemic disease instead of cortical tuber.There is no evidence of subependymal nodules.There is no evidence of abnormal enhancing lesions either. The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.The pituitary gland is normal in size, morphology, signal intensity and enhancement. There is no hypo-enhancement or signal abnormality suggestive of neoplasm. The pituitary stalk is located at midline without deviation, and is normal in caliber, signal intensity and enhancement. The suprasellar cistern, optic chiasm, hypothalamus, and cavernous sinuses are unremarkable. The orbits and contents are unremarkable.
1. Multifocal scattered high signal intensities on FLAIR images indicate non specific small vessel ischemic disease.2. No evidence of acute ischemic or hemorrhagic lesion.3. No evidence of cortical tuber, subependymal nodule or abnormal enhancement.