Other convulsions [780.39] / Altered mental status [780.97], Reason for Study: ^Reason: ams, concern for PRES on ct head vs demyelinating disease History: confusion Extensive high signal intensity lesion on bihemispheric periventricular white matter as well as deep white matter which are directing perpendicular to ventricular lining indicating demyelinating disease such as multiple sclerosis.Underlying brain shows multifocal tissue losses and linear or nodular high signal intensities on FLAIR and T2 weighted images indicating chronic ischemic infarctions on bilateral external capsule, bilateral basal ganglia, bilateral caudate nucleus, and bilateral thalami. There is no evidence of acute ischemic or hemorrhagic lesion.There is no MR evidence of PRES.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.The right maxillary sinus shows retention cyst.
1. Extensive white matter lesions indicating demyelinating disease such as multiple sclerosis.2. Underlying brain shows multifocal chronic ischemic infarctions.3. No acute ischemic or hemorrhagic lesion on this scan.