55-year-old female with history of recent orthotopic liver transplant now with persistent headaches. There is no evidence of acute infarction or intracranial hemorrhage. There are minimal punctate foci of increased T2 signal within the periventricular white matter. There is no abnormal intracranial enhancement. The basal ganglia appear unremarkable bilaterally. There is an arachnoid cyst that measures up to 10 mm in thickness inferior to the left medial temporal lobe with associated remodeling of the skull base. 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, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is minimal fluid within the right mastoid air cells.
1. Minimal punctate foci of increased T2 signal within the periventricular white matter, which is nonspecific, but likely related to chronic small vessel ischemic disease.2. No evidence of acute ischemic infarction or intracranial hemorrhage.3. Small arachnoid cyst inferior to the left medial temporal lobe with associated remodeling of the skull base. 4. Minimal fluid within the right mastoid air cells. 