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Age: 55

Sex: Female

Indication: Bilateral vision loss

Save ("V")

Case #17


Findings

  • Extensive T2/FLAIR signal hyperintensity involving the bilateral parietal and occipital lobes involving gray and white matter with associated gyral swelling and cortical restricted diffusion
  • Additional areas of cortical and subcortical white matter T2/FLAIR hyperintensity involving the bilateral superior parietal lobules and posterior frontal lobes
  • Multifocal areas of susceptibility artifact centered in the bilateral parietooccipital cortices
  • Tiny enhancing extraaxial structure along the high left frontal convexity
  • Remote lacunar infarct in the left caudate head
  • Severe mucosal thickening of the bilateral maxillary sinuses and bilateral ethmoid air cells with fluid layering in the left maxillary sinus and complete opacification of the right maxillary sinus. Mild mucosal thickening of the sphenoid and frontal sinuses


Diagnosis

  • Posterior reversible encephalopathy syndrome (PRES)

Sample Report

Findings are most suggestive of posterior reversible encephalopathy syndrome (PRES) involving the bilateral parietooccipital regions and to a lesser extent the bilateral posterior frontal lobes. Associated areas of developing cortical infarction with multiple small parietooccipital cortical hemorrhages. No evidence of herniation or hydrocephalus.

Tiny enhancing extraaxial structure along the high left frontal convexity, which may represent a tiny meningioma.

Remote lacunar infarct in the left caudate head.

Severe mucosal thickening of the paranasal sinuses. Correlate with clinical signs of acute sinusitis.


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