55-year-old woman with a history of prior right hemiplegia episodes and endocarditis who presented with acute mental status change, slurred speech, and right-sided weakness. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage, intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. There has been interval resolution of many of the previously described supratentorial and cerebellar patchy T2/FLAIR hyperintense regions. There is residual nonspecific T2/FLAIR signal abnormality in the bilateral anterior frontal periventricular white matter, genu of the corpus callosum and the left parietal white matter, which may be related to prior ischemia. There is a small focus of chronic-appearing hemorrhage within the right superior temporal lobe, which was less appreciable on the prior examination likely due to differences in technique. No abnormal parenchymal or meningeal enhancement is evident. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are grossly clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Interval resolution of most of the previously described patchy T2/FLAIR hyperintense regions, consistent with PRES. 2. Chronic appearing FLAIR hyperintensity in the left parietal white matter and bilateral anterior corpus callosum which may be related to prior ischemia or other injury.