32-year-old female with cystic fibrosis altered mental status. Evaluate for abnormalities.Additional EMR Data: pancreatic exocrine insufficiency, recurrent pseudomonas pneumonia, and chronic hemoptysis s/p multiple bronchial embolizations with ongoing hemoptysis presents with AMS and witnessed seizure. Intubated in the setting of low O2 sat, possibly during seizure activity. Limited sequences were obtained. Redemonstrated is diffuse gyriform restricted diffusion in the right greater than left cerebral hemispheres in a watershed distribution, including the right frontal and parietal lobes and left frontal lobe, with underlying white matter cytotoxic edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is scattered paranasal sinus mucosal thickening and secretions, with focal oval FLAIR hyperintense lesion in the right frontoethmoidal recess which may represent a mucous retention cyst or small mucocele.
1.Limited sequences were obtained secondary to patient discomfort.2.Persistent but unchanged gyriform restricted diffusion in the bilateral cerebral hemispheres in a watershed distribution, right more than left, with underlying white matter edema.3.Pansinus disease likely related to cystic fibrosis.