<s>[INST] 30 year old female with headaches coming from the neck area always starting out in the cavity on the left side from the neck vertebrae s, neck and shoulders are in a lot of pain during the headache which without medication lasts several days, person is always very cold (mainly hands and feet), doesn t tolerate heat very well and passes out when too hot, blood pressure always 120/80 or less. If less than 120/80 she has dizziness and vertigo, has short term memory loss, issues with constipation, fatigue, is a carrier of CF but doesn t have the illness. Person was overdosed on Dimenhydrinat when she was 11 years old, which after that noticed a drastic decline in her short term memory. Also was diagnosed with a whiplash at the age of 16 as well as 19 (both car accidents) Below is the report from the MRI findings: TECHNIQUE Multiplanar, multisequence MR imaging of the brain with and without gadolinium. 15 cc Omniscan administered intravenously. FINDINGS There is no intracranial mass, cerebral edema, hemorrhage, or abnormal extra-axial fluid collection identified. There is no acute ischemia. There is no focal cortical encephalomalacia. After gadolinium administration, there is no abnormal enhancement of the brain parenchyma or meninges. There are at least two punctate foci of signal abnormality in the periventricular white matter, located in the deep right parietal lobe, with no associated enhancement or restricted diffusion. These findings are nonspecific, with broad differential diagnosis which includes but is not limited to vasculitis, a demyelinating process such as multiple sclerosis, migraine headaches, toxic exposure, infectious/inflammatory etiologies, hypertension, and chronic microvascular ischemic disease. Findings must be interpreted in the context of clinical and historic information, with followup imaging when and if clinically indicated. If and when a followup MRI is obtained, it should include a sagittal inversion recovery sequence for most sensitive evaluation of the white matter. There is no focal cortical encephalomalacia. No brainstem lesions are seen. The ventricles are normal in size and configuration. There is no Chiari malformation. There is no sellar or parasellar mass identified. There is no cerebellopontine angle mass. There is no sinus disease or mastoid effusion. The orbital contents are unremarkable. Flow is demonstrated in the vertebrobasilar and carotid arterial systems. IMPRESSION 1. Nonspecific small focal signal abnormalities in the right parietal periventricular white matter, with differential diagnosis including but not limited to vasculitis, a demyelinating process such as multiple sclerosis, migraine headaches, toxic exposure, infectious/inflammatory etiologies, hypertension, and chronic microvascular ischemic disease. In a patient of this age, migraine headaches, vasculitis, and a demyelinating process such as multiple sclerosis would be the primary considerations. Findings must be interpreted in the context of clinical and historic information, with followup imaging when and if clinically indicated. Future followup studies should include a sagittal inversion recovery sequence. 2. No intracranial mass, acute ischemia, enhancing neoplasm, sinus disease, or mastoid effusion. [/INST] hellos the report suggests full history and clinical findings have to co-relate radiological and scan findings by a euro specialist, there cannot be evaluation based on reports alone as many suggestive findings are there, and often particular disease findings overlap with other diseases too when not present, hence symptomatology, clinical evaluation, neurological detail examination and history will define the nature of disease, treatment may be done accordingly, please do not worry to get evaluation by correspondence only which may not give correct assessment based advise. Thanks </s>