Previous septic shock, persistently altered: evaluate stroke. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is extensive cerebral white matter confluent T2 hyperintensity. The ventricles and sulci are diffusely prominent due to cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is diffuse fluid signal within the bilateral mastoid air cells.
1. Extensive cerebral white matter confluent T2 hyperintensity is nonspecific, but likely represent the effects of chronic small vessel ischemic disease. No evidence of acute intracranial hemorrhage, mass, or acute infarct. Evaluation for intracranial infection is otherwise limited without intravenous contrast administration.2. diffuse fluid signal within the bilateral mastoid air cells may represent mastoiditis.