65 years Female (DOB:6/17/1950)Reason: 65 yof with h/o renal transplant with persistent headaches, on prograf - r/o PRES History: headachePROVIDER/ATTENDING NAME: SHANNON K MARTIN SHANNON K MARTIN The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Additional T2 and FLAIR hyperintense punctate foci are present in the brainstem. This is minimally/mildly progressed since the prior exam.On susceptibility weighted imaging there are multiple punctate foci of signal loss in the periventricular and subcortical white matter. These were also present on the prior exam and have not changed substantially.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Periventricular and subcortical white matter lesions as well as lesions in the brainstem of a mild degree are nonspecific. At this age they are most likely vascular related. This has only mildly progressed since the prior exam2.There is redemonstration of multiple microhemorrhages scattered throughout the periventricular and subcortical white matter. This is somewhat nonspecific given its distribution. One possibility is related to hypertensive episodes. The pattern may be representative of other cause of microhemorrhages including amyloid angiopathy.