Lupus with neuropsychiatric lupus and catatonia with acute deterioration in mental status. There is persistent mild periventricular white matter T2 hyperintense surrounding the posterior portions of the bilateral lateral ventricles. There is no abnormal intracranial enhancement. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged 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 nonspecific patchy enhancement within the oral tongue.
Unchanged mild residual areas of cerebral white matter abnormity likely related to prior vasculitis, but no evidence of acute infarction or recurrent PRES.