Somnolence [R40.0], Reason for Study: ^Reason: evaluation of white matter abnormality History: AMS There are bihemispheric periventricular white matter confluent high signal intensity lesions on FLAIR/T2 weighted images or on the posterior aspect without evidence of restricted diffusion or associated edema. The high signal intensity lesions are extended toward right cerebral peduncle, pons and medullar. Differential diagnosis include HIV encephalopathy and the differential diagnosis include PML.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
Constellation of above MR findings with clinical history indicate possible diagnosis of HIV encephalopathy and the differential diagnosis include PML.