Acute lymphoblastic leukemia, in relapse [C91.02] / Stiffness of unspecified joint, not elsewhere classified [M25.60], Reason for Study: ^Reason: 20 yo with history of relapsed ALL. Evaluate for intracranial hemorrhage, mass or infarct History: 30 minute episode of right-sided arm and neck stiffness, memory loss, headache. Brain MRINo evidence of acute ischemic or hemorrhagic lesion on the scan.Previously seen bilateral (left greater than right) preseptal swelling appear to be improved. However, precise evaluation is challenging due to motion artifacts. There is no evidence of abnormal enhancement on the scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The mastoid air cells are clear. Mucosal thickening on bilateral maxillary sinuses.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.
1. No evidence of acute ischemic or hemorrhagic lesion. No abnormal enhancement.2. Interval improvement of bilateral preseptal thickening since prior scan.3. Normal brain MRA 