Demographics:
66 years old, Female
Indication:
Encephalopathy
Findings
- T2/FLAIR signal hyperintensity in the bilateral periaqueductal gray matter, medial thalami, hypothalamus, and possibly mamillary bodies
- Scattered T2/FLAIR hyperintensities in the periventricular and subcortical white matter
- Incidental right cerebellar developmental venous anomaly with mild adjacent parenchymal T2/FLAIR signal hyperintensity
- Extra-axial lesion along the lateral aspect of the right temporal lobe with hypointense signal on all sequences
Diagnosis
Wernicke encephalopathy
Sample Report
T2/FLAIR signal hyperintensity in the bilateral periaqueductal gray matter, medial thalami, hypothalamus, and possibly mamillary bodies. Though nonspecific, this distribution of signal abnormality raises particular concern for Wernicke encephalopathy.
No evidence of acute infarct.
Scattered T2/FLAIR hyperintensities in the periventricular and subcortical white matter, which though nonspecific are commonly attributable to chronic small vessel disease.
Extra-axial lesion along the lateral aspect of the right temporal lobe with low signal on all sequences, likely representing bulky dystrophic calcification. Consider postcontrast imaging to assess for associated enhancing mass.
Discussion