Female, 53 years old, with altered mental status and hypertension. Assess for PRES, cerebral edema. Image quality is compromised by motion artifact. A relatively linear region of encephalomalacia is redemonstrated within the right aspect of the pons with associated pontine volume loss. The pontine parenchyma, and to a lesser degree the midbrain parenchyma, show mild ill-defined T2 hyperintensity. There may also be some T2 hyperintensity within the right middle cerebellar peduncle.Elsewhere, only a few scattered punctate foci of white matter T2 hyperintensity are seen. No evidence of cortical or subcortical edema is detected. No restricted diffusion is evident. There are no findings to suggest acute or chronic intracranial hemorrhage. No abnormal fluid collections are seen. The ventricular system is normal in size and morphology.
1.No change in the appearance of a chronic right pontine infarct.2.Ill-defined signal within the remainder of the pons and the midbrain may reflect chronic microvascular ischemic disease or sequelae of degenerating fibers related to pontine infarction.3.No acute intracranial abnormality is suspected. No evidence of cerebral edema is seen. In particular, no findings to suggest PRES are noted.