Syncope, evaluate for structural lesions. No intracranial mass or mass-effect. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. Low-lying cerebellar tonsils are incidentally noted, particularly on the right, measuring up to 6 mm below the foramen magnum. Few scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific. Brain parenchyma is otherwise unremarkable for age.No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of intracranial mass, mass effect, or recent infarct. 2. Cerebellar tonsils are low-lying without clear evidence of Chiari 1. 3. Few scattered nonspecific foci of T2/flair hyperintensity in the supratentorial white matter. MRI of the brain is otherwise unremarkable.