Male, 33 years old, with history of AIDS, off HAART, presenting with headache for about one year and worsening vision. The sulci and ventricles are more prominent than expected for a patient of this age. Prominence of the CSF space along the posterior left cerebellum is also seen. No additional abnormal fluid is detected. No evidence of intracranial hemorrhage is seen.Two small foci of parenchymal T2 hyperintensity are evident, one within the right middle frontal gyrus and one within the right superior frontal gyrus. These are associated with no mass effect or pathologic enhancement. In fact, no evidence of pathologic parenchymal or extra-axial enhancement is identified anywhere. No significant parenchymal edema or mass effect is seen.Paranasal sinus mucosal thickening is evident in the right maxillary sinus and right ethmoid air cells. A mucus retention cyst is seen in the left maxillary sinus. The orbits as visualized are unremarkable though this is a nondedicated exam.
1.Cerebral volume loss greater than expected for the patient's age likely representing sequela of HIV infection.2.Two small nonspecific parenchymal lesions are seen. No evidence of parenchymal edema or pathologic parenchymal or extra-axial enhancement is detected. No findings are seen to suggest intracranial tumor or opportunistic infection.3.Normal variant cisterna magna or perhaps an arachnoid cyst within the left posterior fossa.4.Sinus mucosal inflammatory disease.