42-year-old female with SLE, antiphospholipid syndrome vs DIC, subdural lesion and dural sinus thrombosis on MRI, now with worsening neuro status after anticoagulation. Small right subdural collection is stable in size compared to prior MRI. Again, this could represent chronic subdural hemorrhage or infection. There is no evidence of new intracranial hemorrhage, mass or edema. Continued evolution of right occipital lobe infarct, currently measuring 2.5 x 2.1 cm (series 6, image 16/32). No additional foci of cortical low attenuation is identified.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. Partial opacification of the visualized sinuses are again noted. Nasopharyngeal soft tissue thickening is noted. These findings are likely accounted for on the basis of the patient's intubation status. The mastoid air cells are partially opacified.There is new left facial soft tissue thickening (series 6 image 10/32). Questionable right subretinal thickening (series 6 image 10/32).Microcalcifications within the parotid glands bilaterally associated with punctate hypodensities.
1. Stable small right subdural collection. Please refer to MRI of the brain from 1-3-12 for further comments.2. Continued evolution of right occipital lobe infarct.3. Questionable right subretinal thickening that be due to partial retinal detachment or small subretinal hematoma. Recommend ophthalmoscopy for further assessment if clinically indicated.4. Parotid gland microcalcifications and hypodensities.Please correlate with clinical history for chronic inflammatory process involving the parotid glands bilaterally such as sialadenitis, Sjogren's syndrome, Sarcoid or other.5. New left facial soft tissue swelling. Correlate with clinical examination.6. Opacification of paranasal sinuses and nasopharynx is suspected to be at least in part related to intubation status.Findings discussed with Dr. Chwalisz at 10:30 AM 1/9/2012.