Toxoplasmosis, unspecified [B58.9], Reason for Study: ^Reason: r/o PRES History: somnolence Brain MRIThere are multiple nodular enhancing lesions seen on bilateral cerebellar hemisphere, right mesial temporal lobe and left occipital lobe. Some appear to be either new or not as conspicuous as today on prior scan but others are unchanged since prior scan. The clinical significance of those new or more conspicuous lesions may need clinical correlation.Patchy and confluent T2/FLAIR high signal intensity lesions on periventricular white mater are again seen, unchanged since prior scan. There is no evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci and cisterns are unremarkable. The midline structures and cranial-cervical junction are normal. Opacifications on paranasal sinuses and bilateral mastoid are seen, unchanged since prior scan.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation especially MIP reconstruction images show multifocal luminal irregularities on bilateral MCAs, however, those findings are more likely related to motion artifacts or TOF technique related issues. Source images of TOF review show no evidence of significant luminal narrowing. There is no convincing evidence of luminal irregularities either especially on intracranial arterial system.There is no evidence of intracranial arterial aneurysm.
1. Nodular enhancing lesions seen on right mesial temporal lobe, left occipital lobe and bilateral cerebellar hemisphere. Some lesions are new or more conspicuous than prior and other enhancing lesions are unchanged since prior scan. Clinical correlation is recommended about the disease progression.2. Unchanged confluent/patchy T2/FLAIR high signal intensity lesions on periventricular white mater since prior scan.3. No evidence of acute ischemic or hemorrhagic lesion.4. No evidence of intracranial arterial luminal narrowing or irregularity. If clinically indicated regarding intracranial arterial abnormality. CTA can be considered for more precise anatomical evaluation. 