32 years Female (DOB:3/9/1984)Reason: 32yo with CF, admitted for AMS w/seizure, found to have watershed infarct on previous imaging w/concern for PRES. Has been stable for several days, now with HA w/blurred vision. Eval for acute change. History: headachePROVIDER/ATTENDING NAME: LAURA J CARLSON BRYAN A CAMPBELL MRI of the brainThere is redemonstration of FLAIR and T2 signal hyperintensity involving the right middle frontal gyrus and right precentral gyrus and small portions of the right superior frontal gyrus and right postcentral gyrus as well as a separate focus along the medial aspect of the right superior parietal lobule. Since the prior exam diffusion restriction associated with this has subsided.Previously noted diffusion restriction and FLAIR signal hyperintensity along the small portion of gray matter adjacent to the left superior frontal sulcus and some portions of the right parietal lobe are not identified on the current exam. Currently no FLAIR or T2 signal hyperintensity is clearly appreciated at these locations.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mucosal thickening. The visualized portions of the mastoid air cells demonstrate some scattered opacities in the left ethmoid air cells. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are identified. The left posterior communicating artery has an infundibulum and is small to medium sized. The right posterior communicating artery is tiny. The anterior choroidal arteries can also be identified. There is some fenestration of the distal left A1 segment. The anterior communicating artery is medium-sized. The anterior communicating artery is fenestrated. The left vertebral artery is larger than the right vertebral artery.
1.There are findings compatible with subacute infarction involving the watershed zone along the right hemisphere which includes frontal lobe and parietal lobe.2.Since the prior exam diffusion restriction in the left frontal lobe and portions of the right parietal lobe have not progressed to any significant permanent FLAIR signal hyperintensity.3.There is no evidence for intracranial cerebrovascular occlusive