History of relapsing polychondritis, limbic encephalitis, and left posterior scleritis. Evaluate for structural lesions Brain: There is mild increased T2/FLAIR signal in the hippocampi and bilateral medial and anterior temporal lobes which is less prominent than on the initial exam from 5/10/2014. There is no associated hemorrhage and the volume of the temporal lobe structures is unchanged.There is no intracranial mass or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There are patchy areas of mucosal thickening within the ethmoid air cells. The skull and scalp soft tissues are grossly unremarkable.Orbits: The exam is limited by motion artifact.There is mild thickening of the posterior scleral wall with increased T2 signal and mild enhancement in the mid to lateral retrobulbar fat on the left. The optic nerves are normal in size and signal intensity and are symmetric bilaterally. The extraocular muscles appear normal. No retrobulbar mass, chiasmatic mass, or parasellar abnormality is seen.
1.Mild residual T2/FLAIR signal in the bilateral temporal lobes is slightly less prominent then on the initial exam from 5/10/2014.2.Mild thickening and enhancement of the posterior left sclera and retrobulbar fat is nonspecific but compatible with the history of recent posterior scleritis.