UPRIGHT MRI EXAMINATION OF THE HEAD WITHOUT CONTRAST

UPRIGHT MRI EXAMINATION OF THE HEAD WITHOUT CONTRAST

FINDINGS:                 Axial T1, T2, FLAIR, and diffusion weighted images, sagittal T1, and coronal T2 weighted images were obtained on the upright MRI.  There is an area of abnormality noted in the left medial upper cortex along the falx involving most of the parietal region.  This has edema surrounding it with an area of signal loss on the T1 weighted images and slightly increased signal on the T2 weighted images.  I understand the patient has had history of infarct.  This would correlate with this area.  Question if the patient had history of hemorrhagic infarct.  It is not clear that there is significant hemorrhage at this time, but would recommend clinical correlation or correlation with prior studies or CT as needed.  There are age-related changes consistent with atrophy and small-vessel ischemic disease.  There is question of a few small lacunar infarcts in the basal ganglia region especially on the right versus prominent Virchow-Robin spaces.  These appear chronic in nature.  This is also true in the region of the basal ganglia seen on the right on image 8 and 9 of series 102.  The cerebellar region shows no other significant abnormality.

IMPRESSION:           Changes consistent with an area of infarct in the left parietal region along the falx predominantly.  This is seen on multiple images.  This appears most likely more chronic in nature and question if the patient has an old area of hemorrhage in this area.  Would recommend clinical correlation or correlation with other imaging studies.  There is lacunar infarcts identified in the basal ganglia region and also in the region of the pons predominantly to the right.  These most likely are chronic in nature.  There is also age-related atrophy and small-vessel ischemic disease.  It is not clear that there is significant sulcal effacement.  The area in the high parietal region along the falx may represent some reinfarct ischemia in this region also.  Would recommend correlation with the patient’s other imaging studies.  There is small amount of pituitary tissue and changes suggestive of almost empty sella syndrome.  Please see comments above.  A preliminary report will be given.

Thank you for the referral.

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