Advanced HIV and acute altered mental status. Evaluate for opportunistic infection. There is no evidence of intracranial hemorrhage, mass, or acute infarct. Within the periventricular distribution is a mild T2/FLAIR signal abnormality which is nonspecific but likely from small vessel ischemic disease. There is no evidence of infection or 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. The orbits, skull and scalp soft tissues are grossly unremarkable. There is thickening of the sphenoid sinus with mixed debris and fluid centrally.
1.No evidence of intracranial infection are abnormal enhancement.2.Thickening of the sphenoid sinus with mixed debris and fluid centrally. 3.Mild chronic small vessel ischemic changes.