Male, 60 years old, with worsening altered mental status, word finding difficulty, dyskinesia and tremor in the severely immunosuppressed patient. No restricted diffusion is seen. No evidence of significant parenchymal edema or mass effect is detected. There are a few scattered small nonspecific foci of T2 hyperintensity in the brain. Numerous foci of susceptibility are, however, detected throughout the brain ranging in size from punctate to several millimeters. No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricles are normal in size and morphology.
1.No findings are seen to suggest infection, edema or any other definite acute process.2.Note is made of numerous scattered foci of susceptibility in the brain. These could represent sites of chronic microhemorrhage, amyloid angiopathy, or even sequelae of remote trauma. Correlation with clinical history and cerebrovascular risk factors may be helpful.