Female, 52 years old, with nausea and headache. Evaluate for PRES, venous thrombosis. MRI brain:Numerous scattered foci of predominant periventricular T2 hyperintensity are seen, progressed from the prior examination. No diffusion restriction is seen. No evidence of edema or mass effect is detected. No intracranial hemorrhage or any abnormal extra axial fluid collection is seen. The ventricles are normal in size and morphology. Partially empty sella is noted incidentally. A fluid level is present in the maxillary sinuses.MRI orbits:The globes are round and symmetric. The extraocular muscles demonstrate normal caliber and morphology. The optic nerves are of normal caliber and free of pathologic signal abnormally. The intraorbital fat is clean. No masses are detected.MRA brain:Image quality is slightly degraded by motion artifact. Within this limitation, no high-grade stenosis or occlusion is detected. No aneurysm or vascular malformation is seen. The left A1 segment is hypoplastic. The ACOM artery is prominent. A moderately sized right PCOM artery and a small left PCOM artery are evident. Please note that the venous sinuses are not assessed with MRA technique.
1.Numerous foci of periventricular T2 hyperintensity are seen, progressed from the prior MRI and most compatible with chronic microvascular ischemic disease.2.No evidence of any acute intracranial abnormality is seen. No findings are detected which would be consistent with PRES. 3.Evaluation the orbits is within normal limits.4.No abnormalities of the intracranial arteries are detected.