Diagnosis: Altered mental status, unspecifiedClinical question: eval for PRESSigns and Symptoms: somnolence bone marrow transplantComments: Patient does not need sedation but is on Precedex and Dilaudid so needs appropriate monitoring | There is a mild degree of generalized brain atrophy for the patient's stated age of 22.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 mild mucosal thickening.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is no evidence for cerebral infarction or other intracranial lesion. There is no evidence for posterior reversible encephalopathy syndrome.2.For the patient's stated age of 22 there is a mild degree of generalized brain atrophy present which is unchanged since the prior exam. This is nonspecific but is not significantly changed since the prior exam3.Examination is mildly degraded due to patient motion. This may obscure more subtle abnormalities.