Altered mental status and history of alcoholic cirrhosis of liver with ascites. Many of the images are degraded by patient motion. There is mild cerebral white matter T2 hyperintensity, primarily in a periventricular distribution. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild T1 hyperintensity in the bilateral basal ganglia and pituitary gland. There is also diffuse nonspecific susceptibility effect within the bilateral basal ganglia and midbrain. There is diffuse cerebral and cerebellar volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There are secretions that encompass the entire left maxillary sinus.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct.2. Diffuse cerebral and cerebellar volume loss is likely related to alcohol use.3. Findings suggestive of chronic hepatic encephalopathy.