Fever, unspecified [R50.9] / Altered mental status, unspecified [R41.82], Reason for Study: ^Reason: New area of hypoattenuation in left frontal lobe concerning for ischemia. History: LOC, AMS. There is no evidence of acute ischemic or hemorrhagic lesion on this scan.The left frontal lobe lesion seen on prior CT scan shows focal encephalomalacia with high signal intensity on FLAIR images indicating chronic ischemic lesion.However, there are multiple patchy FLAIR/T2 high signal intensity lesions at bilateral periventricular white matter, splenium of corpus callosum and right temporo-occipital lobe deep white matter including periventricular white matter. Differential diagnosis of these lesion include post transplantation changes/disease related, post-chemotheraphy related lesions, or recurrent Lymphoma/ALL.Other scattered T2/FLAIR high signal intensity lesions at bilateral frontoparietal white matter and left anterior aspect of putamen indicating non specific chronic ischemic disease do not show any significant interval change since prior scan.The ventricles, sulci and cisterns are symmetric except slightly effaced right lateral ventricle occipital horn. 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. Mucosal thickening on bilateral maxillary sinuses and sphenoid sinus.
1. Multifocal T2/FALIR high signal intensity lesions involving right posterior temporal and occipital white matter and splenium of corpus callosum suggest differential diagnosis of post transplantation changes/disease related, post-chemotheraphy related lesions, or lymphoma/ALL.2. No evidence of new acute ischemic or hemorrhagic lesion.