Altered mental status, advanced HIV No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. There is diffuse global supratentorial and infratentorial parenchymal volume loss which is advanced for age. There is moderate degree of confluent T2/FLAIR hyperintensity in the bilateral periventricular and to a lesser degree subcortical white matter, which is nonspecific. Major flow-voids are preserved. Susceptibility-weighted sequence is severely motion degraded limiting evaluation for hemorrhage. No hydrocephalus. No extra-axial collections.There is moderate mucosal thickening involving the right maxillary sinus, right sphenoid sinus and right anterior and posterior ethmoid air cells. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of acute infarct or intracranial mass effect. No findings to suggest abscess or empyema.2. There is confluent T2/FLAIR hyperintensity in the periventricular white matter as well as global parenchymal volume loss which is advanced for age. These findings while nonspecific can be seen with HIV encephalopathy. Advanced chronic small vessel ischemic disease, if there are vascular risk factors, may also be considered.3. Moderate paranasal sinus opacification on the right.