Male, 56 years old, with history of renal transplant and disseminated nocardia, follow-up examination. The previously mentioned edema inducing lesions scattered throughout both cerebral hemispheres and the right cerebellum all remain evident and all show progressive surrounding T2 hyperintensity which suggests worsening edema and/or increasing lesion size. As before, most of these lesions demonstrate some degree of diffusion restriction.Several scattered new foci of T2 hyperintensity are seen which do not, however, show correlating restricted diffusion. For example, new lesions are evident within the left middle frontal gyrus, along the left lateral ventricular body, within the right thalamus, along the left occipital horn, and in the right middle temporal gyrus.Some of the above-mentioned lesions demonstrate minimal susceptibility effect, but otherwise, no significant intracranial hemorrhage is detected. No abnormal extra-axial fluid collections are seen. Redemonstrated is evidence of T2 hyperintensity within the dorsal medulla and pons of uncertain etiology. The ventricles are stable and normal in size.
Numerous edema-inducing lesions are demonstrated within both cerebral hemispheres and cerebellum, all of which show progressive edema and/or frank increase in lesion size. Several new small foci of signal abnormality are also noted which, while nonspecific, may represent further progression of the presumed disseminated Nocardia infection.