Reason: 39 y/o lady w/ a hx of HIV and high fevers. History: 39 y/o lady w/ a hx of HIV and high fevers.. There is no evidence of intracranial hemorrhage, mass, or acute infarct. Scattered punctate subcortical (10-20 per hemisphere) and to a lesser degree periventricular T2 and FLAIR hyperintensities are nonspecific and not associated with diffusion restriction. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is deformity of the medial wall of the right orbit with tethering of the medial rectus, appearing similar to prior CT. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are enhancing lesions along the anterior aspect of the parotid gland bilaterally, likely lymph nodes.Metal artifact from dentition partially degrades imaging at orbits and distorts DWI and SWI imaging anteriorly.
Scattered periventricular and subcortical T2 hyperintensities are nonspecific. Differential diagnosis includes chronic migraines, small vessel ischemic disease, demyelinating disease and other inflammatory etiologies.