 MRI Brain:There are multiple cortical/subcortical T2/FLAIR hyperintense lesions without mass effect in the right greater than left frontal lobes and right paramedian parietal lobe. These are not associated with restricted diffusion or contrast enhancement and there is no evidence of intracranial hemorrhage. The brain parenchyma and pituitary gland otherwise appear unremarkable. 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. Mild left sphenoid sinus mucosal thickening.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, and internal cerebral veins are patent. There is no evidence of venous thrombosis.
1.Several cortical/subcortical foci of T2/FLAIR signal abnormality in the right greater than left frontal lobes as well as right paramedian parietal lobe. Findings most likely represent PRES. Alternative etiologies such as encephalitis can be considered in the appropriate clinical setting but seem less likely.2.No evidence of intracranial arterial or venous abnormality.