Diagnosis: Other symptoms and signs involving the musculoskeletal systemClinical question: Rule out focal brain findingSigns and Symptoms: Upper and lower extremity weakness, altered mental status Minimal artifact from patient's dentition distorts the appearance of the frontal lobes and obviates visualization of the orbits.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.
Examination is partially degraded due to metal artifact which obscures some visualization of the orbits and paranasal sinuses and degrades visualization of the frontal lobes. The brain is only partly visualized on susceptibility imaging (which would be used to identify foci of hemorrhage). To extent of visualization no abnormal mass lesion is appreciated to account for the patient's upper and lower extremity weakness and altered mental status.