My brother has had increasingly debilatating symptoms of tinnitus, headaches, numbness on the side of the face, dizziness, nausea, vertigo, nasal congestion, muscle pain with no diagnosis. He has had two MRI's. the first one in 2007 was a gadolinium enhanced MR venogram. findings were "no signs of space-occupying lesion. 2 tiny nonspecific hyperintense foci along the inferior right subinsular region on the T1 and T2 weighted images. Patent, unremarkable dural sinuses. symmetric increased signal in the torus tubarius/normal variant related to the cartilaginous portion of the eustachian tubes. the second MRI was without gadolinium and found: several tiny ill-defined nonspecific subcortical white matter hyperintensities within the right frontal lobe, without restricted diffusion or blooming on gradient-echo sequence. Lobulated mucosal thickening of the maxillary sinus bilaterally, with air fluid levels. mucosal thickening of the ethmoid complex. The first mri was done to investigate headaches, the second to investigate the tinnitus. Should he be concerned about the increasing number of hyperintensities? Any suggestion as to where to turn next to get a definitive diagnosis?
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