New onset seizures and ESRD due to renal agenesis, inflammatory myopathy, APLS, Raynaud's, HTN, and colitis. There are scattered areas of subcortical white matter T2 hyperintensity predominantly involving the left parietal and occipital lobes, and to a lesser extent portions of the right cerebral hemisphere. There are also scattered foci of T2 hyperintensity in the deep white matter. The hippocampi are unremarkable and there is no evidence of heterotopia. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids appear to be grossly intact. There are artifacts related to dental braces.
Scattered white mater lesions in the bilateral cerebral hemispheres predominantly involving the left parietal and occipital lobes likely represent posterior reversible encephalopathy syndrome versus less likely a demyelinating or infectious process, although characterization is limited by the lack of intravenous contrast (acknowledging the patient's renal failure). Discussed with Dr. Ardelt on 3/26/2015 at 10:15 AM.