Encephalopathy, unspecified [G93.40], Reason for Study: ^Reason: evaluate for encephalitis History: pt with acute confusion, hashimoto encephalitis Significant motion artifacts degraded exam quality.There are multifocal bihemispheric restricted diffusion lesions which most are new lesions comparing to prior scan. Previously seen multifocal restricted diffusion lesions are most likely not demonstrating diffusion restriction on today's scan. On FLAIR images, both prior restricted diffusion lesions and current new lesions all show high signal intensity.Especially those prior lesions with high signal intensity on T2/FLAIR images show progressed volume loss. Those lesions include right parietal inferior parietal lobule, left parieto-occipital lobe, right temporal lobe and right occipital lobe with corresponding ventricles show ex vacuo changes. There is no evidence of hemorrhagic lesion on this scan.There is no evidence of abnormal enhancement on this scan.The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Interval development of multifocal new non enhancing bihemispheric restricted diffusion lesions.2. Interval progression of volume loss (encephalomalacia) on previously seen high signal intensity lesions on T2/FLAIR as described above.