 MRI Brain:There is relatively well-demarcated, nonenhancing, T2/FLAIR hyperintense region of cortical and subcortical thickening within the right parietal precuneus. The lesion measures approximately 12 or 13 mm in maximal dimension. There is little if any associated mass effect.There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. Incidental note is made of a right frontal developmental venous anomaly. There is no midline shift or herniation. The major cerebral flow voids are intact. There is dependent fluid in the sphenoid sinus and patchy fluid in the right mastoid air cells.MRA Brain: The intracranial internal carotid arteries demonstrate no significant stenosis. The middle and anterior cerebral arteries are also patent. The vertebral arteries, basilar artery, and posterior cerebral arteries also are patent with no significant stenosis. No evidence of aneurysms or vascular malformations.MRV 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.Cortical and subcortical signal abnormality and thickening in the right parietal precuneus. The differential diagnosis for this finding is broad and would include a focal dysplasia, low-grade neoplasm or simply seizure related edema. An isolated lesion of PRES or vasculitis would be somewhat unusual but still possible. An infectious or inflammatory etiology would also warrant consideration.2.Normal MRA and MRV of the brain.