Female, 14 years old. History of SLE, chronic HA. Ophthalmologic exam on 9/2/15 showed possible bilateral disc swelling vs pseudopapilledema. BRAIN:There is no evidence of intracranial hemorrhage, mass effect, midline shift, or acute infarct. Mild prominence of the ventricles and sulci appear similar to the prior study, compatible with global volume loss. The basal cisterns remain patent. The midline structures and craniocervical junction are within normal limits. Small areas of T2 hyperintensity within the left paramedian parietal lobe and anterior left frontal lobe are unchanged from the prior study dated 08/2014, without associated diffusion restriction or enhancement. There is no abnormal parenchymal or leptomeningeal enhancement. There is no diffusion abnormality.ORBITS:No abnormal mass or abnormal enhancement is seen. The optic nerves are normal in size and signal intensity. There is no definite elevation of the optic nerve head. No retrobulbar, chiasmatic, or parasellar abnormality is seen. The extraocular muscles are unremarkable.MRA:The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.MRV:The 2-D MRV sequences are somewhat limited, and there is better evaluation of the venous structures on phase contrast images and 3-D T1 postcontrast images of the brain. The superior sagittal sinus, inferior sagittal sinus, transverse sinuses, sigmoid sinuses, straight sinus, vein of Galen, internal cerebral veins, and several visualized cortical veins are patent. There is no evidence of venous thrombosis.
1.Nonspecific small areas of T2 hyperintensity in the left paramedian parietal lobe and left frontal lobe are unchanged from the prior study.2.Normal MR appearance of the orbits, without morphologic or signal abnormality involving the optic nerves.3.The intracranial arterial and venous structures are normal, without aneurysm, flow-limiting stenosis, or thrombosis.