History of kidney transplant now with central sleep apnea. Evaluate for PRES versus encephalitis. No evidence of acute ischemia. Again seen is a bandlike region of increased T2 signal in the bilateral middle cerebellar peduncles and crossing the pons. The pontine abnormal signal may be slightly increased in conspicuity, although this may be related to differences in technique. No associated mass effect. No additional parenchymal signal abnormalitiesThere is no evidence of mass or edema The ventricles and basal cisterns are normal in size and configuration. The expected intracranial vascular flow voids are present. The visualized mastoid air cells are partially opacified bilaterally, increased from prior.
Stable bandlike increased T2 signal in the bilateral cerebellar peduncles and crossing the pons. Findings remain nonspecific and the differential considerations remain an atypical form of posterior reversible encephalopathy syndrome, drug toxicity, or other toxic metabolic syndrome.