Clinical question: Evaluate for structural lesion to explain encephalopathy, headache, visual changes. Signs and symptoms: As above. Pre-and post-enhanced brain MRI:Negative diffusion weighted series.There is normal anatomical morphology of the brain parenchyma. There is normal signal intensity of brain parenchyma on all MRI sequences.The unremarkable surgical cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.There is normal visualization of intracranial major arterial branches. There is normal signal intensity are intracranial venous sinuses.There is no detectable abnormal parenchymal, leptomeningeal, calvarial or orbital abnormal enhancement.Minimal chronic sinus disease is identified. Bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
Negative pre-and post enhanced brain MRI.