Reason: Evaluate for abnormal enhancement, possible infl CNS disorder History: Altered mental status, facial nerve palsy, suspected infl. CNS disorder The CSF spaces are appropriate for the patient's stated age with no midline shift. There is diffuse marrow replacement throughout the calvarial structuresNo abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 are clear. The visualized portions of the mastoid air cells demonstrate minor opacities. The visualized portions of the orbits demonstrate small eyeballs with heterogeneous appearing fluid suggestive of blood products.Incidental is made of partial empty sella.
1.No abnormal lesions are appreciated intracranially to explain the patient's symptoms. However, examination is limited due to the fact that the patient was unable to adequately cooperate with exam. No post contrast imaging was performed. Many of the imaging sequences were repeated.2.Diffuse marrow replacement is a nonspecific finding which can be seen with chronic disease, anemia, lymphoproliferative or myeloproliferative disorders. Please correlate with clinical findings. (The patient's current hemoglobin level is 8.2 which may provide an explanation)3.Pthisis bulbi with intraocular hemorrhage and atrophy of the eyes. The patient is known to have prior history of uveitis and iridocyclitis.