Clinical question: Evaluate AMS in transplant patient. Signs and symptoms: Confusion; no neurological deficit. Pre-and post-enhanced brain MRI:There is no detectable acute intracranial process and in particular no evidence of acute ischemic stroke present.Examination demonstrate multiple punctate foci of flair hyperintensity in the subcortical and periventricular white matter of cerebral hemispheres. There is extensive similar signal changes within the pons present. Signal intensity are present parenchyma is otherwise unremarkable. Although the findings are nonspecific this appearance is often result of microvascular ischemic changes. There is a slight prominence of cortical sulci which may be at the upper limits of normal for age.Unremarkable ventricular system, CSF spaces and myelination of brain otherwise. The signal void of major intracranial arterial branches are identified.Anatomical variation of partially empty sella is identified. Post enhanced images are negative for abnormal enhancement of brain parenchyma, leptomeninges or the calvarium. Unremarkable images through the orbits and including axial fat sat post enhanced series.
1.No evidence of acute intracranial process.2.Finding suggestive of minimal chronic small vessel ischemic disease in the subcortical and periventricular white matter and more extensively of the pons as detailed.3.Anatomical variation of partially empty sella is identified.4.Unremarkable pre-and post enhanced brain MRI otherwise.