Anoxic brain injury. History of myoclonus and decrease level of consciousness. Patchy and confluent areas of restricted diffusion are seen within the cortex and white matter of the bilateral cerebral hemispheres, symmetrically involving the posterior frontal and parietal lobes and the corona radiata down to the posterior limbs of the internal capsules. There is also mild restricted diffusion involving the globus pallidi with conspicuous T2 hyperintensity of the globus pallidi and putamina. There is no evidence of intracranial hemorrhage or mass. 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 orbits, skull, and scalp soft tissues are grossly unremarkable. There is fluid seen in the bilateral maxillary sinuses with air-fluid levels as well as complete filling of the sphenoid sinuses and near complete filling of the ethmoid sinuses fluid.
1. Patchy and confluent areas of restricted diffusion and T2 signal abnormality involving the bilateral cerebral hemispheres, including cortex, white matter and deep gray nuclei, compatible with anoxic brain injury.2. Severe paranasal sinus inflammation.