56 years Female (DOB:1/29/1960)Reason: r/o crypto History: MRI brain with lesionPROVIDER/ATTENDING NAME: SCOTT STERN SCOTT STERN There are patchy foci of T2 and FLAIR signal hyperintensity along the basal ganglia bilaterally more so on the right basal ganglia anteriorly compared to the left. There is some associated T1 signal hyperintensity but no significant susceptibility effect. On the postcontrast imaging there is no convincing evidence for contrast enhancement.There are patchy foci of T2 and FLAIR signal hyperintensity within the brainstem. The left pons is suspected more than the right pons. There are several punctate foci of T2 and FLAIR signal hyperintensity in the thalami and internal capsules.On susceptibility weighted imaging and postcontrast imaging there appears to be a developmental venous anomaly present in the right thalamus.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Lesions in the basal ganglia especially in the right side are suspicious for involvement with cryptococcus given the patient's clinical history. 2.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions as well as hyperintense patchy lesions in the brainstem and thalami present identified on the FLAIR and T2 images. Although they are nonspecific, most likely these are vascular related.