What is on the differential for diagnosis?

[mern215]

Dizziness upon standing with intermittent parathesias to all extremities.  Blood work for various disease processes all negative.  

MRI BRAIN W/O CONTRAST
1. No mass lesion, no hemorrhage, no acute ischemia.
2. Scattered white matter signal foci, unusual for age.  Clinical correlation advised.  Consider neurologic consultation, particularly if demyelinating disease is a clinical concern

MRA BRAIN W/O CONTRAST
1. Suggestion of increased number/tangle of vessels along the left pons, within the left pontine cistern (series 8, image 89 through 105/166) and along the expected territory of the left superior cerebellar artery, for which underlying vascular malformation is not entirely excluded.
Recommendation: CTA.
2. Increased flow related enhancement along the left ophthalmic artery likely represents normal artery  (series 3, image 108/166), however this can be further evaluated on dedicated CTA to exclude underlying aneurysm.

MRI CERVICAL SPINE W&W/O CONT :
1. Non-enhancing, fusiform cord signal at C6-T1, likely dilated central canal versus syrinx. No abnormal cord enhancement. Clinical correlation advised.  2. No evidence of demyelinating cord lesion in the cervical or thoracic spine.   No abnormal enhancement.

MRI THORACIC SPINE W&W/O CONT

1. Non-enhancing, fusiform cord signal at C6-T1, likely dilated central canal versus syrinx. No abnormal cord enhancement. Clinical correlation advised.  2. No evidence of demyelinating cord lesion in the cervical or thoracic spine.   No abnormal enhancement.

MRI LUMBAR SPINE
1. Mild disc bulge at L3-4 with left foraminal extent, resulting in moderate left neural foraminal narrowing at this level. Disc likely abuts the exiting left L3 nerve root. Probable associated annular tear, as described above.
2. Mild L4-5 with minimal bilateral foraminal extent resulting n mild right greater than left neural foraminal narrowing.