Diplopia s/p major burn. Brain: There are several T2 hyperintense lesions within the cerebral white matter with associated enhancement in some cases, but no appreciable mass effect. The largest lesion is located in the left gyrus and medial orbitofrontal gyrus, measures up to 20 mm, and displays incomplete ring enhancement. There is also a punctate focus of T2 hyperintensity in the right pontomedullary junction anteriorly. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and paranasal sinuses are grossly unremarkable. There appears to be slight skin thickening corresponding to areas of burn injury.Orbits: There are no intraorbital mass lesions or abnormal enhancement. The globes, optic nerves, and ocular adnexa appear to be intact.
1. Multiple white matter lesions, some of which are associated with enhancement. The largest lesion is located in the inferior left frontal lobe and measures up to 20 mm. In addition, a punctate lesion involves the right anterior pontomedullary junction, which may compromise the right abducens nerve. These may represent a demyelinating or other inflammatory process and less likely neoplasm or atypical infection.2. The orbits are unremarkable.